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^r^ CORNELL UNIVERSITY. 

Vl/J^p THE 

THE GIFT OF 

RdSWELL P. FLOWER . 

FOR THE USE OF 

THE N. Y. STATE VETERINARY COLLEGE 
1897 

8394-1 



CMT «^^ ..Cornell University Library 
SF 911.W72p1890 



Tlje principles and practice of veterlnar 





3 1924 003 653 452 




The original of tiiis book is in 
tine Cornell University Library. 

There are no known copyright restrictions in 
the United States on the use of the text. 



http://www.archive.org/details/cu31924003653452 



PRINCIPLES AND PRACTICE OF 
VETERINARY SURGERY. 




HORSE IN SLINGS 



THE 



Principles and Practice 



OF 



VETERINARY SURGERY. 



WILLIAM WILLIAMS, 

F.R.C.V.S., F.R.S.E., Etc. 

EX-PRESIDENT OF THE ROYAL COLLEGE OF VETERINARY SURGEONS ; PRINCIPAL, AND PROFESSOR OF 

VF,TEKINARY MEDICINE AND SURGERY AT THE NEW VETERINARY COLLEGE, EDINBURGH ; 

EXAMINER IN VETERINARY HYGIENE FOR B.SC. (AGRICULTURE), EDINBURGH UNIVERSITY; 

PROFESSOR OF VETERINARY SURGERY AND EXAMINER IN AGRICULTURE FOR THE 

HIGHLAND AND AGRICULTURAL SOCIETY OF SCOTLAND ; FOREIGN 

CORRESPONDENT OF THE SOCI^T]^ CENTRALE DE MEDICINE 

V^T^RINAIRE : AND AUTHOR OF " THE PRINCIPLES 

AND PRACTICE OF VETERINARY MEDICINE." 



SEVENTH EDITION. 

REVISED BY THE AUTHOR, ASSISTED BY HIS SON, 
W. OWEN WILLIAMS, F.R.C.V.S., F.R.P.S. 



NEW YORK: 

SABISTON & MURRAY, 916 Sixth Avenue. 

1890. 



PRINTED FOR THE AUTHOR BY J. SKINNER & COMPANY, 
AND PUBLISHED BY 

JOHN MENZIES & CO., EDINBURGH AND GLASGOW. 

London, .... J. & A. Churchill. 

New York, . . Sabiston & Murray. 

Toronto, ... . . Williamson & Co. 



CONTENTS. 



CHAPTER I. 

Inflammation. 



PAdR 



Definicion — Pathology — Phenomena — Causes — Varieties due to Causation 
— Local Symptoms — Chronic Inflammation — Terminations — Eesolu- 
tion — Effusion, ...... 1-30 

CHAPTEE, II. 

Terminations of Inflammation — eontinned. 

Suppuration — Acute Abscess — Difliise Suppuration — Superficial Suppura- 
tion — Comparison between Pus, Mucus, and Epithelium — Pyogenic 
Paver or Strangles — Pysemia — Ee-absorption of Pus — Formation of 
Sinuses — Ulceration — Varieties and Treatment of Ulcers — Morti- 
fication. ....... 31-59 

CHAPTER III. 

Symptoms of Inflammation. 

General Symptoms of Inflammation — Inflammatory Appearances of the 
Blood — Treatment of Inflammation — Treatment of Chronic Inflam- 
mation, ....... 60-77 

CHAPTER IV. 

Feactdees and Diseases of Bones. 

Causes of Fracture — Symptoms — Modes of Union — Treatment of Frac- 
tures — Compound Fractures — Separation of Epiphyses — False Joints 
and Non-Union, ..... 78-90 

CHAPTER V. 

Paktioulab Feactukes. 

Fractures of Inferior Maxilla — Fractures of Anterior Maxilla and of other 
Facial Bones — Fractures of Cranial Bones — Fracture by " Counter 
Stroke" — Concussion of the Brain — Hernia Cerebri, . 91-116 



VI CONTENTS. 

CHAPTER VI. 

Paetioulab Fraotukks — continued. 

PAGB 

Fractures of the Vertebrae — On Broken Back — Fracture of the Sacral and 
Coccygeal Bones — Fracture of the Pelvic Bones — Fracture of the 
Femur — Fracture of Tibia; — Fracture of the Tarsal and Metatarsal 
Bones 117-130 

CHAPTER VII. 

PAKTionLAR Feaotuees — continued. 

Fractures of Scapula — Humerus — Condyles — Olecranon — Radius — Ulna 
— Trapezium, Carpal, Metacarpal, and Sesamoid Bones — "Split 
Pasterns" — Navicular and Pedal Bones — Broken Ribs — Luxations — 
Case of Dislocation of Third Cervical Vertebra, . , 131-145 

CHAPTER VIII. 

Diseases op the Bones and Aetioulations. 

Classification of the Bones — Ostitis — Sore Shins — Splints — Peculiarity of 

Splint Lameness — Scrofulous Ostitis, . . . 148-164 

CHAPTER IX. 

Diseases or the Bones and Articulations — continued. 

Ulceration— Caries — Necrosis — Central and Subperiostal Suppuration 

— Abscess in the Substance of a Bone, . . . 165-177 

CHAPTER X. 

Non-Inelammatoet Diseases of Bones. 

Rickets — Mollities Ossium — Osteo-Porosis — Fragilitus Ossium — Osteo- 
sarcoma — EflFects of Mercurial Poisoning on Bones, . 178-201 

CHAPTER XL 

DiSKASES OE THE JolNTS. 

Classification of the Joints — Anchylosis of the Vertebrae — Acute Syno- 
vitis — Chronic Scrofulous Synovitis — Calcification of the Synovial 
Fringes — Rheumatoid Arthritis — Kennel Lameness — Morbid Condi- 
tion of Cartilage — Traumatic Inflammation of Joints — Hydrops 
Articulormn — Anchylosis, ..... 203-229 

CHAPTER XIL 

Lameness. 
Diagnosis — Definition — Signs — Causes — Congenital Muscular Atony 



CONTENTS. . vii 

PAOR 

Methods of Examination— Sprains — Strains of Psose Muscles — 
Chorea — Stringhalt — Shivering — Myositia — Eheumatic T,ameness — 
EmboU, ....... 231-252 

CHAPTER XIII. 

Partiol'lah Lamehesses. 

Shoulder Lameness — Shoulder-Slip — Elbow Lameness — Sprain of Radial 

or Superior Carpal Ligament — Carpitis, . . . 253-268 

CHAPTER XIV. 

Pauticulab Lamenesses — continued. 

Speedy Cut — Broken Knees — Sprain of Elexor Tendons — Sprains of 
Suspensory Ligament — Sprain of Fetlock- Joint — Sesamoiditis — Ring- 
Bones, ....... 269-290 

CHAPTER XV. 

Pakticulab Lamenesses— coTjiireued. 

Hip-Joint Lameness — Sprain of Gluteal Tendons, or Trochanteric Lame- 
ness — Sprain and Atrophy of Crural Muscles — Stifle-joint Lameness 
— Laceration of Flexor Metatarsi Muscle, . . , 291-298 

CHAPTER XVI. 

Particular Lamenesses — continued. 

Diseases of the Hock — Bog-Spavin — Bone-Spavin — Conformation of Hock 
most subject to Spavin — Thorough-Pin — Capped Hocks — Injuries to 
Gastrocnemii Muscles — Curb, ..... 299 316 

CHAPTER XVIL 

Treatment of Lameness. 

Eest — Position of the Limb — Removal of Shoes- -High-Heeled Shoe — 
Thin-Heeled Shoe — Hot and Cold Fomentations — Local Bleeding — 
Purgatives — Counter-irritants — Blisters — Setons — Actual Cautery- 
Theory of their Action, ..... 317-324 

CHAPTER XVIII. 

Diseases op the Feet. 

Preliminary Observations on Shoeing — Foot Lameness, divided into three 
kinds : (1.) Diseases of the Bones and Cartilages ; (2.) Diseases of the 
Horn-Secreting Structures; (3.) Accidental Injuries — Disease of the 
Pyramid of Os Pedis — Side-Bones — Navicular Disease, Theories of 

Causes, Pathology, and Treatment — Neurotomy, its favourable 

and unfavourable Effects — Gelatinous Degeneration of the Navicular 

Bursa — Pathological Anatomy — Comparison to Whito Swelling, 325-355 



viii CONTENTS. 

CHAPTER XIX. 

Diseases of the 'Feet— continued. 

PAGE 

Inflammation of the Feet — Divisions of Lamiuitis — Pathological Changes 

— Causes — Symptoms — Treatment — Mr. Broad's Treatment, . 356-369 



CHAPTER XX. 

Diseases of the Tebt — eontinued. 

Diseases of the Horn-Secreting Structures — Villitis — Carbuncle of Coro- 
nary Band — False-Quarter — Sand-Craok— Horn Tumours — •Seedy- 
Toe-Corns— Thrush— Canker, .... 370-386 



CHAPTER XXI. 

Diseases of the 'FmLt— continued. 

Punctures of the Feet by "Gathered Nails" and by "Pricks" in Shoe- 
ing — Importance of thoroughly examining Wounded Feet and of 
giving Exit to all Discharges — Weak Feet liable to Injuries — - 
— Quitter — Treatment — Foul in the Foot of Horned Cattle — Foot- 
Kot in Sheep, ....... 387-406 



CHAPTER XXII. 

Tumours. 

Classification, ....... 408-411 

CHAPTER XXIIL 

Simple Tumours. 

Fibroma or Fibrous Tumour — Papilloma — Lipoma — Neuroma — Enohon- 
droma — Cru-ita-Petrosa Tumours — Psammoma — Osseous Tumours — 
Osteoma — Parasitic Cysts — Cystic Tumours — Teeth Tumours — 
Sarcomata — Melanosis — Actino-Myoosis — Carcinomata — Hard 
Cancer — Soft Cancer — Epithelial Cancer, . . . 412-447 

CHAPTER XXIV. 

Wounds. 

Definition — Classification — Incised— Punctured — Lacerated — Contused^ 
Gun-Shot — Poisoned — Treatment of Wounds — Sutures — Collodion — 
Styptic-Colloid — Shellac Paste — Non-Interferenee, . . 448-457 



CONTENTS. it 

CHAPTER XXY. 
Wounds — continued. 



FAQS 



Gim-Shot — Cannon Balls — Wind Contusions — Musket-Shot — Grape-Shot 
— Small-Shot — Consequences of Gun -Shot Wounds — Wounds of 
the Abdominal Parieties— Wounds and Bruises having Special Names 
— Bums, Scalds, and the Effects of Cold — Poisoned Wounds— 
Speedy -Cut — Tread — Cutting or Brushing, , . . 458-472 



CHAPTER XXVI. 

Wounds — continued. 

Methods of Repair — Immediate Union — Primary Adhesion— Granulation 
— Secondary Adhesion — Healing under a Scab — Formation of the 
Cicatrix, and Completion of the Reparative Process, . . 473-483 



CHAPTER XXVII. 

Results op Wounds. 

Erysipelas, Simple and Phlegmonous — Symptoms and Treatment — 
Tetanus, Idiopathic and Traumatic — Various Eorms of — Symptoms 
— Pathology— Treatment, ..... 484-492 

CHAPTER XXVIII. 

Diseases and Injueies op the Facial Region. 

Wounds of the Lips — Tumours — Bruises of the Mouth — Affections of the 
Buccal Membrane — Sporadic Aphthae — Paralysis of the Lips — Open 
Parotid Duct — Salivary Calculi — Ptyalism — Ranula — Epulis — Glos- 
sitis — ^Ulcer and Induration of the Tongue in Homed Cattle — Para- 
lysis of the Tongue, ...... 493-503 

CHAPTER XXIX. 

Diseases and Injubies op the Facial Region — continued. 

Parrot-Mouth — Irregularities of the Teeth — Diseases of the Alveolar Pro- 
cesses — Caries of the Teeth — Diseases of Dentition — Dental Irrita- 
tion in Voung Cattle — Dental Cough in Young Horses — Dentition 
Fever — Supernumerary Teeth — Diseases of the Facial Sinuses — 
Ozceua, or Nasal Gleet, ..... 604-527 

CHAPTER XXX. 

Diseases op the Phaeynx, CEsophagus, &o. 

Post-Pharyngeal Abscess — Pus in the Guttural Pouches — Pharyngeal 
Polypi — Choking, Clinical Records of — (Esophagotomy — Dilatation 
and Stricture of the (Esophagus — Wind-Sucking and Crib-Biting, 528-541 



X CONTENTS. 

CHAPTER XXXI. 

Diseases of the Eyes. 

PAGE 

Conjunctivitis — Nebiite — Albugo — Staphyloma — Ulcers — G laucoma — 
Amaurosis — Strabismus — ^Eotropium — Entropium — Trichiasis — Dis- 
tichiasis — Warts — Wounds — Haws — Lachrymal Fistula — Stricture — 
Parasites — Fungus HEematodes — Periodic Ophthalmia — Cataract — 
Eemoval of Eyeball — Dislocation of Eyeball — Melanosis of Humours 
— Examination of Eye by Catoptric Test and by the Ophthalmoscope, 542-585 

CHAPTER XXXII. 

Diseases op the Head, Neck, Veins, &o. 

Otorrhcea — External Canker of the Ear — Poll-Evil — Fistulous Withers — 
Circumscribed and Diffuse Phlebitis — Thrombus — Varicose Veins — 
PWebolites — Entrance of Air into the Veins, . . 566-577 

CHAPTER XXXIII. 

Diseases of the Akteeies and Lymphatics. 

Diseases of the Arteries — Arteritis — Embolism — Aneurism — True Aneur- 
ism — The Dissecting Aneurism — False Aneurism — Aneurismal Varix 
— Varicose Aneurism — Degeneration of the Arterial Coats — Cal- 
careous, Cartilaginous, and Fatty Degeneration — Injuries to Arteries 
— Inflammation of the Absorbents, . , . , 578-595 

CHAPTER XXXIV. 

Hekni«, &o. 

Reducible — Irreducible and Strangulated Herniae— Umbilical or Exom- 

phalos — Ventral, Inguinal, and Scrotal Hernise — Gut-Tie in Cattle, 596-622 

CHAPTER XXXV. 

Diseases of the Bladder, External Organs of Urination, &o. 

Diseases of the Bladder, Vagina, Vesioulae Seminalis, Mammary Gland, 
&c. — Cystic Calculi in the Horse, Ox, Sheep, and Dog — Lithotomy 
— Lithotripsy — Lithotrity — Urethral and Preputial Calculi — Sabul- 
ous Matter — Urethritis — Phymosis — Paraphymosis — Am putation of 
the Penis — Vaginitis — Leucorrhoea — Mammitis, . . 623-641 

CHAPTER XXXVL 

Castration. 

Castration — Precautions to be observed before the Operation is performed 

— Methods of Operating — Consequences of Castration — Svfelling 

Hernia — Scirrhous Cord — Fistula of the Scrotum — Peritonitis— Gan- 
grene — Tetanus — Paralysis — Amaurosis— Glanders and Farcy, 642-654 



CONTENTS. xi 

CHAPTER XXXVII. 

Diseases oi' the Skin. 

PAGE 

Classifications : Willan and Bateman's, Bennett's, and Buchanan's — Ery- 

Uiematous Inflammations — Clipping Horses — Herpes — Urticaria, 655-666 

OHAPTEE XXXVIII. 

Diseases or the Skin — continued. 

Definition — Division — Various Forms of Eczema — Simplex — Eubrum — - 
Lichen — Impetiginodes — Acute and Chronic Grease — Elephantiasis 
— Crusta Labialis — Treatment of Eczematous Eruptions — Eflects of 
Carbolic Acid on the Dog-, ..... 667-678 

CHAPTER XXXIX. 

Diseases or the Skin — continued. 

I. Squamous Inflammation of the Skin — Psoriasis — Pityriasis— II. Dis- 
ordered Sensibility of the Dei-ma — Prurigo — III. Inflammation of 
the Sebaceous Follicles — Acne — Sitfasts — Treatment, . 679-684 

CHAPTER XL. 

Diseases oe the Skin — continued. 

Scabies — Different Varieties of Acari — Sarcoptes — Dermatodectes — Sym- 
biotes — Classification — Experiments of Hering, Hertwig, and others 
as to the Transmissibility of the Mites to Man — Mange in the Horse 
and Ox — Scab in Sheep — Mange iu the Dog and Cat — Treatment of 
Mange — Diseases due to Epizoa — Poultry Lousiness — Fleas — Ticks — 
Bots— Maggots, ...... 685-712 

CHAPTER XLL 

Diseases of the Skin — continued. 

Faras, or Honeycomb Ring- Worm— Experiments of Gruby— The Achorion 
Sohonleinii — The Yellow Crust due to the Exudation — Trans- 
missibility of the Disease from Animals to Man, and tnce versa — 
Tinea Circinatus — The Tricophyton discovered by Malmsten — 
Identity of Favus and Tinea Circinatus — Letter from Mr. 
M'Gillivray of Banfl— Treatment of Ring-Worm, ■ • 713-721 

CHAPTER XLIL 
Castins, . 722-724 



CHAPTER XLIIL 
Anaesthesia, . . . . - 



725-726 



LIST OF ILLUSTRATIONS. 



PHOTO-LITHOGRAPHS. 

Diseases of the Bones and Articulations, 
Diseases of the Joints, 
Anchylosis, or Stiffening of the Joints, 
Tumours, .... 

LITHOGRAPHS. 

Horse in Slings, . 

Three Views of Mr. Walker's Face Cradle, 
Actino-Mycosis, . 
Casting by means of Side Lines, . 
Do. by means of Hobbles, 



PACE 

147 
202 
230 
407 



Frontispiece 

. 95-96 

441 

722 

723 



WOODCUTS. 

FIG. 

1. Web of Prog's Foot, showing First Stage of Inflammation, . 7 

2. Irregular Contraction of Small Vessels in the Web of a Frog's Foot 

after the application of Stimuli, .... 8 

3. Parenchymatous Keratitis, ..... 13 

4. Inflammation and Gelatinous Degeneration succeeding Neurotomy, 20 

5. Purulent Granulations, ...... 32 

6. Examples of Cells, ...... 32 

7. Cells from Fresh Catarrhal Sputa, .... 33 

8. Pus-Corpuscles, ....... 33 

9. Oblique Fi'acture of the Tibia, with External (Enshealhing) Callus, 80 

10. Fracture of Metatarsus, showing the Plug within the Medullary Canal, 81 

11. Indirect Comminuted Fracture of Basilar Process of Occipital and 

Sphenoidal Bones, ...... 104 

12. Fracture of Neck of Femur, ..... 126 

13, 14. Split Pasterns, ....... 136 

15, 16. Fracture of Navicular Bone, ..... 138 

17. Trochlea of the Femur, showing the efiects of Friction from Luxation 

of Patella, ....... 143 

18. Dislocated Neck, ... • ■ . . 145 

19. Inferior Extremity of Tibia in a Healthy Condition, . . 152 

20. Inferior Extremity of Tibia in a State of Ulceration, . . 152 

21. Sore Shin, ....... 154 

22. Compound Splint, . .... 166 

23. Ordinary Splint, ....... 153 

24. Instrument for Pyro- Puncture, ..... 159 



LIST OF ILLUSTEATIONS. 



Xlll 



FIO. 

25. 

26. 

27, 28. 

29, 30. 

31, 32. 

33-35. 

36. 

37, 38. 

39-41. 

42, 43. 

44. 

45. 

46. 

47. 

48. 

49. 

50. 

51. 

52, 53. 

o3a. 

54. 
65, 56. 

57. 

68. 

69. 
60. 
61. 
62. 

63-65. 
66. 
67. 
68. 
68a. 
69. 
70. 
71. 
72. 
73. 
74. 

75. 
76. 
77. 
78. 

79. 

80. 

81. 

82-84. 



178, 



Necrosis Totalis, . 

Section of the Bone represented in Fig. 25, 

Abscess in Bone, . 

Eickets, .... 

Osteo-Porosis of Cranio-Faoial Bones, 

Effects of Mercury on Bones of Dog, 

Healthy Cartilage, 

Diseased Articular Cartilage, 

Diseased Cartilage, 

Eepair of Cartilage, . 

False Eing-Bone, 

High Eing-Bone, 

Low Eing-Bone, . 

Eing-Bone involving the Os Suffraginia, 

Disease of Trochanter Major, 

Eupture of Flexor Metatarsi, 

Boue-Spavin, 

Astragali united to show the Screw Lines, 

Bone-Spavin, 

Ocoiilt Bone-Spavin, 

Spring Truss for Thorough-Pin and Bog-Spavin, 

Horse-Shoes, 

The Foot prepared for the Shoe, . 

Ossiiication of the Lateral Cartilages ; Fracture of the altered 
Structure upon one Side, .... 

Phalangeal Bones in their naturally Oblique Position, 

Position of Phalangeal Bones altered by a Thick-Heeled Shoe, 

Longitudinal Sections of Four Navicular Bones, . 

External Appearance of Inferior Articulating Surfaces of fou 
Navicular Bones, 

Ulceration of Cartilage, . 

Effects of Neurotomy, 

Section of the Foot with its various Parts in a healthy Condition 

Formation of a Horny Exudate at the Toe, 

Perforation of the Horny Sole by the Toe nf the Pedal Bone, 

Eibbed Appearance of Foot after Laminitis, 

Absorption of Inferior Edge of Oa Pedis, 

Advanced Atrophied Condition of Os Pedis, 

Mr. Broad's Shoe, ..... 

Homy Foot, showing Horn Tumour, 

Pedal Bone of same Foot, showing a Cavity at its Toe corre 
spending to the Horn Tumour in Fig. 73, 

Bony Spiculse on Plantar Surface of Os Pedis, 

Bistouri Cach6, . . . 

Confirmed Stage of the First Form of Foot-Eot, 

Condition of Internal Wall of Digit in an Early Stage of Foot- 
Eot, .... 

Condition of a Foot four weeks after the Febrile Stage of Foot- 

aud-Mouth Disease, .... 
Perpendicular Section of an Aocuminated Condyloma, 
Fat Cells, ..... 

Enchondi'ooia, ...... 418, 



PAGE 

170 
171 
176 
179 
185 
201 
215 
216 
217 
221 
285 
286 
287 
287 
292 
297 
302 
305 
308 
310 
311 
327 
327 

330 
337 
338 
343 

344 
346 
352 
358 
358 
358 
359 
359 
360 
367 
378 

378 
381 
390 
400 

400 

402 
415 
416 
419 



LIST OF ILLUSTRATIONS. 



S5. Crusta-Petrosa Tumour, .... 

85. Development of Teeth, 

87. Diagram of Development of Dentigerous Tumour, 
89-90. Lymphadenoma Cells, 
91-92. Actlno -Mycosis, . 

93. Epithelial Cancer from Palate of Ox, 
94-107. Microscopic Anatomy of Cancer, . 

108. Vertical Section of a Granulating Sore, 

109. Speculum Oris, . 

110. SkuU cut open to show the situation of Bony Partition of 

Superior Maxillary Sinus, 

111. Aneurism of the Posterior Aorta, 

112. Inguinal Hernia, 

113. Scrotal Hernia, . 

114. Clams for Castration, 

115. Torsion Forceps, . 

116. Sarcoptea Hippopodus, 
117-119. Sarooptes Hominis (Aoarus Scabie), 

120. Sarcoptes Equi, 

121. Dermatodectes Equi, 

122. Symbiotes Equi, 

123. Dermatodectes Bovis, 

124. Symbiotes Bovis, 

125. Dermatodectes Ovis, . 

126. Sarcoptes Ovis, from abovt, 

127. Sarcoptes Ovis, from beneiith, 

128. Sarcoptes Suis, . 

129. Sarcoptes Canis, . 
130-132. Three Follicles of the Skin of the Dog, containing Entozoa, 

133. Sarcoptes Cati, . 

134. Branches of Achorion Schonleinii, 

135. Fragments of the Branches more highly developed, 

136. Thalli, Mycelia, and Sporidia of the Achorion Schonleinii, showing 

the Mode of Eeproduction, 

137. Isolated Crusts of Favus, 

138. Hairs containing Branches of the Achorion Schonleinii, 

139. Microscopic Appearance of Ring-worm Crust after the addition of 

Liquor Potassse, ...... 

140. Carlisle's Muzzle, ...... 



PAGE 

420 
431 
432 
441 
441 
447 
447 
479 
511 

519 
582 
603 
606 
644 
645 
672 
687 
688 
690 
691 
694 
695 
696 
699 
699 
700 
700 
701 
705 
714 
714 

714 
716 
717 

721 
725 



PRINCIPLES AND PRACTICE OF 
VETERINARY SURGERY. 



THE 

PRINCIPLES AND PRACTICE 



OF 



VETERINAKY 8URGEEY. 



CHAPTEE I. 

INFLAMMATION, 



DEFINITION PATHOLOGY — PHENOMENA CAUSES VARIETIES DUE TO 

CAUSATION ^LOCAL SYMPTOMS CHRONIC INFLAMMATION TER- 
MINATIONS RESOLUTION EFF USION. 

The process of inflammation is the most important of all mortid 
actions and conditions. 

It has been variously defined by different investigators, ac- 
cording to what they conceived it to be. Thus Hunter says 
it is simply an increased action of the vessels. In Mr. Syme's 
opinion, it is "a perverted action of the capillary system, generally 
attended by heat, redness, pain, and swelling.''" Dr. Alison de- 
scribes it as " a peculiar perversion of nutrition or of secretion;" 
and Dr. Aitken defines it as " a complex morbid process charac- 
terised (1.) by a suspension of the concurrent exercise of function 
among the minute elements of the tissue involved; (2.) by 
stagnation of the blood, and abnormal adhesiveness of the blood 
discs in the capillary vessels contiguous to the tissue elements 
whose functions are suspended; (3.) by contraction of the 
minute arteries leading to the capillaries of the affected part, 
with subsequent dilatations and paralysis of the contractile 
tissue of the affected blood-vessels." Dr. Burdon Sanderson 
defines it to be "a succession of changes which occur in a 



INFLAMMATION. 



living tissue when it is injured, provided that the injury is not 
of such degree as at once to destroy its structure and vitality." 

If I were to attempt to give a definition of inflammation, I 
would say that it is a perverted nutrition of a living part, the 
el'fect of irritation or injury. 



PATHOLOGY. 

If a non-vascular structure — the cornea, for example — be 
excised in the following manner, as recommended by Professor 
von Eecklinghausen, changes which are identical with the 
earliest of the inflammatory process may be observed. 

" The anterior chamber is first punctured so as to let out a 
drop of aqueous humour, which is placed on the object-glass ; 
the cornea is then excised and placed in the drop with Desce- 
met's membrane uppermost. The preparation thus obtained is 
examined without a cover-glass, in a closed chamber in which 
the air is saturated with moisture, so that no evaporation can 
take place, and consequently no alteration in the density of the 
liquid in which the cornea is immersed. The healthy cornea 
is absolutely transparent, and when it is examined under the 
microscope, in the manner described, no structure can be dis- 
tinguished. This homogeneity, so essential to the function of 
the cornea, is a condition inseparable from life ; if the observa- 
tion is continued tiE the tissue begins to die, its structural 
elements gradually come into view — first the epithelia, then 
the lymphoid elements proper to the tissue, then the cornea 
corpuscles. The explanation of the fact is, that whereas in life 
the elements of which the cornea is formed affect light exactly 
in the same degree, their respective refractive powers are slightly 
altered in the act of dying. 

" If a cornea is examined in the same way, which has been 
irritated a quarter of an hour before by the application of a 
point of caustic to its surface, the conjunctival epithelial layer 
can at once be distinguished, along with a few leucocytes, 
underneath and among the epithelial elements. If an hour or 
two has elapsed, the proper cornea corpuscles are visible, as 
dark stellate or spindle-shaped spots on a transparent ground. 
Of these some are homogeneous, and can be distinguished from 
the surrounding substance by a slight difference of shade. In 



PATHOLOGY. 3 

others, which are finely granular, the processes or rays are sub- 
ject to slight variations of contour. These amoeboid movements 
of the rays, although very sluggish as compared with those of 
young protoplasm in general, are rendered much more active by 
subjecting the preparation to a stream of blood serum ; for which 
purpose Professor Strieker employs the serum of the same animal 
which has furnished the cornea." 

From the above we learn that the application of an irritant 
produces changes similar to those which take place in a structure 
when first removed from the influence of vitality, and that in 
so far it simulates the first ^post mortem changes. In a vascular 
structure the alterations of nutrition which result from the ap- 
plication of an irritant are as described in the following pages. 

It must be borne in mind that the blood is composed of a 
solid and a fluid portion. The fluid, liquor sanguinis, com- 
posed of albumen, the constituents of the fibrine, water, and 
various salts in solution; the solid, of two kinds of corpuscles, 
the white and the red. The red corpuscles move rapidly along 
in the centre of the stream of blood in a small vessel ; whUe on 
either side, and close to the walls of the vessel, there is a clear 
space called the lymph space, containing Hquor sanguinis and 
a few white globules, which move much more slowly than the 
blood in the centre of the stream. 

The fluid part of the blood is that chiefly concerned in nutri- 
tion. It contains the nutritive elements in solution, and is 
absorbed by the various textures. The capillaries consist of a 
single coat of protoplasm, so that the nutritive material can 
easily pass out of them, and nutrition i." carried on entirely in 
the tissues which fill up the spaces between the capillaries. 
Every tissue has an inherent power of attracting and selecting 
from the blood — which, be it remembered, flows slowly at the 
side of the vessel — those constituents best suited for its nourish- 
ment. 

From this it will be seeii that the fluid part of the blood is 
continually transuding through the walls of its vessels, for the 
purpose of nourishing the tissues. A perversion of this, with a 
rapid transformation of the transuded material, and an altered 
mode of the growth of the elements of the inflamed texture, con- 
stitute the inflammatory process. When the tissue is irritated, 
lymph is produced in such abundance that the lymphatics are 



4 INFLAMMATION. 

unable to convey it away ; it accumulates in the part, forming 
the inflammatory exudate. 

Eeasoning upon the foregoing, one is tempted to conclude 
that inflammation is characterised by an increased nutrition of 
the part ; but such is not the case. During all the processes 
of inflammation there is no such thing as an increased forma- 
tion of the natural structures of the inflamed part — they are 
not even maintained; and it is only after the inflamma- 
tion has subsided that there is an increased formation of 
some of the tissues, as the areolar, the bony, and the horny 
structures. 

"WMlst the inflamed structure itself suffers deterioration, the 
process of inflammation is, however, characterised by a produc- 
tion of lowly organized material. 

Having now endeavoured to show what I conceive to be the 
essential nature of inflammation, viz., a perverted nutrition, con- 
sequent on injurious irritation of tissues, I shall call attention 
to the series of experiments that have been made to demonstrate 
the 

PHENOMENA OF INFL.VMMATION. 

The latest observers state that the microscopically visible 
changes that occur in a transparent vascular membrane of 
an animal, such as the web of the frog's foot, differ con- 
siderably, according to the irritant employed. A weak solution 
of caustic soda, dilute sulphuric acid, &c., produce dilatation, first 
of the arteries, and subsequently of the capillaries, with marked 
acceleration of the circulation, followed by arterial contraction 
and capillary anaemia. But liquor ammoniee, and carbonate of 
ammonia in substance, appear always to occasion a certain de- 
gree of primary arterial contraction, which begins in one or two 
minutes after excitation, and is attended with retarded flow 
of blood through the capillaries; distension of the branches 
given off by the artery nearer the heart, and increased activity 
of circulation in the neighbourhood of the irritated part. This 
state of things lasts for an hour or two, and is succeeded by 
dilatation and acceleration. Croton oil appears to occupy an 
intermediate position between the first-named stimulants and 
ammonia; for while it always gives rise to acceleration of 
the flow of blood as a primary result, this change is some- 



PnENOMENA. 5 

times associated with widening, sometimes with narrowing, of 
the arteries. 

When the mesentery of the frog is spread out and examined 
microscopically, the first change which is observed in the circu- 
lation, as a result of the exposure to air, consists in dilatation 
and increase in the length — manifested by more or less contor- 
tion — of the arteries. The dilatation begins immediately, and is 
preceded by no contraction. It is, however, progressive; the 
diameter of the artery gradually increases for ten or twelve 
hours, at the end of which period it is often twice as great as 
it was before : having thus attained its maximum, its size re- 
mains unaltered for many hours. This dilatation of the arteries 
is followed by a similar change in the veins ; but inasmuch as 
there is a considerable interval between the two events, a time 
occurs at which the arteries, instead of being sensibly smaller than 
the veins which correspond to them, far exceed them in diameter. 

Along with these changes, the rate of movement of the blood 
is also altered. At the beginning of the process the circulation 
is quicker than natural. Although the two changes go on at 
the same time, the acceleration cannot be regarded as a result 
of the increase of calibre ; for the inevitable consecLuence of 
dilatation would be diminution, not increase, of the rate of 
movement, supposing the activity of the heart and the resistance 
opposed by the capillaries of distribution to be the same. The 
absence of any relation between the two is stiU more clearly 
shown by what is observed at a later period; for whereas, 
on the one hand, as has been already stated, the dilatation lasts 
for many hours, the acceleration is confined to the first stage of 
the process. The rate of movement soon becomes normal, and 
this is shortly followed by a change in the opposite direction ; 
so that by the time the arteries are fully dilated, the circulation 
is much slower than it was originally. 

Many experiments have been made with the view of account- 
ing for the dilatation and contraction of the arteries and capillary 
blood-vessels, and the most important results of these are — that 
division of a vasa motor nerve produces congestion of all the 
tissues to which it is distributed ; that excitation by the inter- 
rapted electrical current, or by mechanical means, produces con- 
striction of the minute arteries presided over by the irritated 
nerve, and conseq^uent anaemia ; that excitation of a sensoiy nerve 



6 INFLAMMATION. 

produces increased activity of the capillary circulation in the 
part in which the nerve originates ; and iinally, that all arteries 
manifest alternating states of contraction and dilatation — move- 
ments independent of those of the heart, and of breathing — and 
ceasing when the vessels are paralyzed by division of their nerves. 

Reference- to the effect of croton oil shows that acceleration 
of the flow of the blood through the vessels of the irritated 
part is sometimes associated with widening, sometimes with 
narrowing of the arteries; and in order to judge whether the 
acceleration in the one condition is of a similar or of an opposite 
nature to what it is in the other, investigators have observed 
both conditions simultaneously in the same part. If, for 
example, in the web of the frog's foot the acceleration due to 
electrical excitation of the central end of the sciatic nerve is of the 
same nature as inflammation, we should expect it to be increased 
by local irritation; and, conversely, the effect of irritation, if 
already existing, to be heightened by exciting the nerve. The very 
careful experiments of Dr. Riegel show that it is so. Having 
found that after section of the sciatic nerve the effects of irritation 
were slightly retarded, but otherwise unmodified, he repeated the 
observation in another animal, excited the central end, and then 
applied croton oil to both webs. On the injured side the 
accelerating effect of the croton oil lasted much longer than on 
the other, so that at the time stasis had already set in on the 
sound side, the circulation was going on more briskly than 
natural on the injured side. — (Buedon Sandeeson.) 

From the foregoing observations, the reader will gather that 
acceleration of the flow of blood through the part is the only 
constant fact observable, whether the cause be the reflex electrical 
stimulation of a nerve, or the direct irritation of the part by 
agents which induce either contraction or dilatation. 

In all forms of inflammation of sufSeient intensity, the circu- 
lation, after a varying period of excitation, becomes retarded. 
The current then ceases, the vessels at the same time become 
greatly distended, and the blood globules adherent to certain 
parts of the sides of the vessels, and to each other, so that 
their individual forms can no longer be distinguished. In some 
cases the vessels have fusiform dilatations of their whole 
circumference at certain points of their course, or at short 
intervals pouches sprout from the sides of their walls. These 



PHENOMENA. 7 

pouches are not, however, peculiar to the inflammatory state, 
and they have been ascribed to structural derangement of the 
walls of the vessels, in consequence of which they cannot present 
an equable resistance to the column of blood, and consequently 
the blood becomes extravasated into the surrounding textures. 

Some have affirmed that constriction of the vessels never 
takes place prior to their dilatation. This, as already ex- 
plained, has arisen from the kind and strength of the irritant 
used by these observers ; whilst others state that, during con- 
traction, the blood is seen to flow more rapidly through them, 
and that this is explaiaed by the well-known fact that 




!FlG. 1. — An exact copy of a portion of the web in the foot of a young frog, after 
a drop of strong alcohol had been placed upon it. The view exhibits a deep-seated 
artery and vein, somewhat out of focus ; the intermediate or capillary plexus run- 
ning over them, and pigment cells of various sizes scattered over the wliole. On 
the left of the figure the circulation is still active and natural. About the middle 
it is more slow, the column of blood is oscillating, and the corpuscles crowded 
together. On the right, congestion, followed by exudation, has taken place. 

a. A deep-seated vein, partially out of focus. The current of blood is of a deeper 
colour, and not so rapid as that in the artery. It is running in the opposite direc- 
tion. The lymph space on each side, filled with slightly yellowish blood plasma, is 
very apparent, containing a number of colourless corpuscles) clinging to, or slowly 
moving along, the sides of the vessel. 

b. A deep-seated artery, out of focus, the rapid current of blood allowing nothing 
to be perceived but a reddish-yellow broad streak, with lighted spaces at the sides. 

Opposite c, a laceration of a capillary "vessel has produced extravasation of blood, 
which resembles a brown spot. 

At d, congestion has occurred, and the blood corpuscles are apparently merged 
in one semi-transparent reddish mass, entirely filling the vessels. The spaces of the 
web between the capillaries are rendered thicker and less transparent, partly by 
the action of the alcohol, partly by the exudation. This latter entirely fiUs up the 
spaces, or only coats the vessels, 200 diameters. — (Bennett.) 

liquids flow more rapidly through a narrowed tube. This is not 



8 



INFLAMMATION. 



the case, for, as Paget observes, " As the vessels are contracting, 
the blood flows in them more slowly, or begins to oscillate ; nay, 
sometimes, I think, even before the vessels begin visibly to 
contract, one may observe that the blood moves more slowly 
in them, as if this were an earHer effect of the stimulus ; nor 
have I seen (what has been commonly described) the acceleration 
of the flow of blood in the contracting vessels." He again 
remarks — " It has been commonly said, that as the vessels con- 
tract, therefore the movement of blood becomes more rapid in 
them, as when a river entering a narrow course moves through 
it with a faster stream, and that then, as the vessels widen, so 
the stream becomes in the same proportion slower. But thisi 
is far from true ; the stream becomes slower as the artery or 
vein becomes narrowed by contraction, and then, as the tube 
dilates, the stream grows faster, and then, without any appreci- 
able change of size, it may become slower again, till complete 
stagnation ensues in, at least, some part of the blood-vessels." 
Now, the reader must remember that arteries are supplied with 
muscular or contractile power, and when they are acted upon by 
any influence which causes a contraction of their muscular coat, 
they must, of course, become narrower, inasmuch as the muscular 
cells lie in rings around them. The consequence then is, that 
less blood penetrates the part of the body supplied by such 
arteries. The more muscular an artery is, the more lasting anci 




Fig. 2.— Irregular contraction of small vessels in the web of a frog's foot after 
the application of stimuli. — (Wharton Jones.) 

forcible is the contraction, and the greater the obstruction ex- 



PHENOMENA. 9 

perienced by tlie current of blood. In the smaller vessels the 
contraction is rapidly succeeded by dilatation, which continues 
for a longer or shorter period. When an artery is really in 
action it gives rise to no hjrpersemia ; on the contrary, the more 
active the vessel, the less blood will pass through it. The con- 
traction of the vessels is very irregidai, as will be seen from the 
preceding engraving (Fig. 2). 

If contraction of the vessel be the first change observed, it is 
succeeded by dilatation, and, as already stated, the stream of 
blood may become faster. Then, without any change being 
observed in the size of the vessels, it becomes slower, oscillates, 
and finally completely stagnant, constituting stasis or passive 
congestion. 

The contraction of the vessels can be produced by the appli- 
cation of a stimulus to the nerves supplying them, and the 
relaxation by cutting these nerves. Prom this we conclude — 
and the fact is an important one — that relaxation of the mus- 
cular fibres of the vessels can be produced by paralysis of the 
nerves that supply them, or by an interruption of the nervous 
influence, from whatever cause it may proceed. That the capil- 
laries have the power of contraction has been demonstrated by 
Professor Lister, who has shown that this contractility is de- 
pendent on fusiform (spindle-shaped) cells, which have the power 
of shortening themselves, and which run transversely round the 
delicate membrane that forms the walls of the capillaries. 

The stoppage of the blood (or stasis) has now to be accounted 
for, and this is difficult of explanation, as no mechanical 
obstruction has ever been seen to present itself If there is no 
obstruction, why should there be a stoppage ? 

Some pathologists have asserted that the vessels become 
mechanically plugged up by the red corpuscles adhering to the 
sides of them (Boeehave) ; by multiplication of the colourless 
corpuscles, and by change in the specific gravity or viscidity of 
the blood in a part (Wharton Jones), or of the corpuscles in 
particular (Bruecke) ; obstruction of the venous circulation (G. 
Eobinson) ; or adhesiveness of the blood corpuscles (Lister). 
These opinions have been combated by Professor Bennett, who 
says, "That the blood corpuscles indeed have a tendency to 
aggregate together is certain, and I have frequently seen what, 
Mr. Lister has described, namely, a roU of them projecting from 



10 INFLAMMATION. 

a side vessel iuto a large one, and oscillating in the current 
■without separating; but that this is produced by a viscous 
condition of these bodies, which causes their surfaces to stick 
together, as he appears to think, is negatived by the fact that 
not unfrequently I have seen one or more of them approach 
rapidly a vessel in the inflamed tissue not yet obstructed, then 
proceed slowly, oscillate for a while, until at length, getting 
beyond the diseased parts, it has again darted off with the same 
velocity as it came. Again, it may frequently be observed, 
when a vessel is so full of coloured corpuscles that they can 
no longer be distinguished, and seem to have melted together, 
that, on rupturing it, these bodies, when extravasated, at once 
assume their original form, and arrange themselves just the 
same as they do coming from a healthy structure. I cannot 
suppose, therefore, that the cause of stasis is connected with 
adhesiveness of the blood corpuscles; indeed, many of the 
valuable observations of Mr. Lister himself only confirm what 
I have long maintained, namely, that they simply are drawn 
together and brought more closely into contact by some external 
force, which is excited by irritation of the surrounding tissue." 

Later experiments have to some extent confirmed the con- 
clusions of Bennett. Dr. A. Eyneck has made some experiments 
in the Physiological Laboratory at Gratz, upon the production 
of stasis, and has shown that all its phenomena can be produced 
by irritation in the webs of frogs, in which milk or defibrinated 
blood of mammalia has been substituted for the circulatin'^ 

a 

fluid. If a web so treated be touched with a rod moistened 
with ammonia, the phenomena of stasis occur in the irritated 
part; the capillaries become crowded with milk globules, ex- 
hibiting the appearance of grey cords. When defibrinated blood 
is used, the results are even more striking, for in this case the 
choked vessels soon exhibit in every respect the same appear- 
ance as in ordinary inflammation. 

These results seem to make it perfectly clear that the local 
changes which lead to the production of stasis must have their 
seat either in the walls of the vessels, or in the tissues which 
immediately surround them. To determine this more precisely. 
Dr. Eyneck varied this experiment by filling the vessels with 
an indifferent liquid, such as a solution of common salt of 
proper strength, so as to remove the blood ; then subjecting their 



PHENOMENA. 11 

internal surface for a few moments to an agent, wliicli, by virtue 
of its chemical action, might be expected to modify or destroy 
its vitality, such as solution of chromic acid, chloride of gold, or 
sulphate of copper. The results were decisive : no stasis was 
produced by irritation in webs which had been thus treated. 

It has been observed that there is an apparent increase of the 
white corpuscles in the inflamed part, and a remarkable disposi- 
tion in them to adhere to the walls of the vessel; but as no 
pores are visible in the capillaries under the highest magnifying 
powers, the fact that the white corpuscles passed through the 
vessels into the tissues, which was pointed out by Dr. Addison, 
and which has now been proved, could not be accepted ; but in 
1846 the statements . of Dr. Addison were confirmed by Dr. 
Augustus Waller, who says (FMlosopMcal Magazine, vol. xxix., 
p. 397, 1846), " In some instances the manner in which the cor- 
puscle escaped from the interior of the tube could be distinctly 
followed ; that part of the tube in contact with the external side 
of the corpuscle gradually disappeared, and at nearly the same 
time might be seen the formation of a distinct line of demarca- 
tion between the inner segment of the corpuscle and the fluid 
parts of the blood in contact with it. Any slight agitation then 
was capable of disengaging the corpuscle from the vessel to 
which it was now external." The escape of the corpuscle was 
supposed by Dr. "Waller to be due to an exudate being given 
off from the corpuscle possessing some solvent power over the 
vessel, or that the solution of the vessel took place in virtue of 
some of those molecular actions which arise from the contact of 
two bodies ; actions which are known as exerting such extensive 
influence in digestion, and referable to what is termed the 
catalytic power. But it is now proved that the capillaries 
consist of protoplasm, hence the penetration of their contractile 
walls by the amoeboid corpuscles, and the subsequent closure 
of the openings when the passage is completed, can be readily 
understood. 

In order to do this it must be further borne in mind, as 
pointed out by Prof. Cohnheim, that a white corpuscle— leuco- 
cyte, sarcophyte— is not a cell in the sense in which the term 
was formerly used, but is a mass of contractile material en- 
dowed with the faculty of movement. This movement, from 
its similarity to that possessed by the amcebse, has been termed 



12 INFLAMMATION. 

amoeboid, and is as follows : — The mass constantly changes its 
form. But as this goes on in all parts of the hyaline substance, 
of which it consists, simultaneously, the only way in which it 
can be understood is by confining the attention to one point 
at a time ; it will then be seen that each act of movement begins 
by the budding of a ray, or process of contractile substance m 
a centrifugal direction. What next happens varies in different 
cases. Sometimes the projection subsides just in the same way 
as it was formed; at others, the finely granular fluid, which 
occupies the more central parts of the corpuscle, streams into 
the offshoot, gradually widening it out until it grows into a mass 
greater than the remainder, which it finally draws into itself. 
It is evident that the process last described must always be at- 
tended with locomotion, for each time it is repeated the whole 
mass rallies round a new centre, the position of which cor- 
responds to the extremity of the offshoot. 

As already stated, these white corpuscles accumulate in large 
numbers in the vessels of the inflamed part in close contact with 
the walls. They then sink into the substance of the walls, and 
pass through them into the surrounding tissue. During this 
process it is seen that the corpuscle pierces the walls of the 
vessels by means of prongs of a delicate homogeneous material, 
similar at first to a shining thread. Some of these prongs pro- 
ject, and as a prong increases in length it thickens at its base ; 
the substance of the corpuscle now tends towards it, becoming 
smaller as the prong gets larger ; in fact, the contents of the 
corpuscle are drawn into the substance of the prong, which be- 
comes rounded off at its tip, and finally assumes the contour of 
the corpuscle. Having escaped from the vessels into the sur- 
rounding tissue, the corpuscles continue their active movements, 
and increase rapidly in number. 

Virchow describes two forms of inflammation, namely — (1st.) 
The parenchymatous inflammation, where the process runs its 
course in the interior of the tissue elements {e.g., connective 
tissue cells, or germ masses, hepatic and cartilage cells), with- 
out one being able to detect the presence of any free fluid which 
has escaped from the blood ; and (2d) The secretory (exudative) 
inflammation of superficial tissue elements, where an increased 
escape of fluid takes place from the blood, and conveys the new 
products of growth and altered secretion with it to the surface. 



PHENOMENA. 



13 



Virchow is also of opinion that there is no inflammatory exuda- 
tion at all, in the sense in whicli it has usually/ heen assumed to 
exist, but that the exudation is essentially composed of the 
material which has been generated in the inflamed tissue itself, 
through the change in its condition, and of the transuded fluid 
derived from the vessels. If a part possesses a great number of 
vessels, particularly if they are superficial, it wiU be able to 
furnish an exudation. If this is not the case, there will be no 
exudation, but the whole process will be limited to the occur- 
rence in the real substance of the tissue of the special changes 
which have been induced by the inflammatory stimulus ; and 
he concludes by stating that every parenchymatous inflamma- 
tion has, from its outset, a tendency to alter the histological 
and functional character of an organ. Every inflammation witli 
free exudation in general affords a certain degree of relief to the 
part ; it conveys away from it a great mass of the noxious matters 
with which it is clogged, and the part therefore appears com- 
paratively to suffer much less than that which is the seat of a 
parenchymatous disease. 

Of the former (the parenchymatous) he gives an example in 




FlH. 3.— Parenchymatous Keratitis. At A the cornea corpusclea are seen in a 
nearly normal condition, at B enlarged, at C and D still more enlarged, and at 
the same time clouded. 350 diameters. — (Virchow.) 

inflammation of the cornea; and of the latter form of inflam- 
mation we have an example as it occurs in mucous membranes, 



14 INFLAMMATION. 

where generally no fibrine is formed, but mucus, whicb does 
not exist in the blood. An inflamed mucous membrane pro- 
duces large masses of epithelium in a short time; they are 
merely products of the membrane, which is not infiltrated with 
epithelium or mucus coming from the blood, but the peculiar 
product of the membrane, and is conveyed to the surface by 
means of the fluid transuding from the blood. In the same 
manner, iibrine, instead of being a real exudate from the 
vessels, is a local product of the tissues on and in which it 
is found, and is conveyed to the surface, as in pleuritis, in the 
same way as the mucus of the mucous membrane. We can 
thus explain that the fibrinous condition of the blood observed 
in inflammations is a result of the absorption of the increased 
quantity of fibrine produced by the local metamorphosis of 
transuded serum. 

We may conclude that the effect of inflammation on all living 
tissues is a modification of the action of individual cells, result- 
ing from some alteration in the properties of the walls of the 
capillaries nearest to the seat of irritation or injury. Most of 
these modifications are accompanied by transudation of liquor 
sanguinis — exudative inflammations ; whilst in others, and these 
are the most destructive, the process is limited to textural 
changes in the substance of the part — parenchymatous inflam- 
mation. The latter may, however, in some instances be 
changed into the former, by increasing the stimulus, or by 
elevating the vitality of the part; for, as already observed, 
the first change noticeable in a non-vascular structure when 
irritated is similar to that seen in the same structure when 
removed from the influences of vital action, i.e., excised, and that 
those processes, peculiar to the inflammatory state, are the natural 
changes occurring in an injured living structure. Now, if the 
living structure be much debilitated by any cause previous to 
the occurrence of the irritation, the natural response will be 
feeble, delayed, or the part may even die without presenting any 
signs of exudative reaction. 



'■"o 



CAUSES OF INFLAMMATION. 

It will be sufficient here merely to notice the remote causes 
of inflammation. These may be divided into predisposing 



CAUSES OF INFLAMMATION. 15 

and exciting causes : — 1st. Predisposing causes are influences 
not of themselves essentially irritant, yet often co-operate with 
others in inducing the inflammatory process. They may be 
summarised as follows — debility either of an organ or of the 
whole body arising from old age ; previous disease or a natxtral 
weakness; hereditary taint or predisposition; obstruction of 
the blood-vessels ; plethora ; climatic influences ; dietetic errors ; 
insufficient ventilation, and ill-treatment of all kinds. 

2d. Exciting or determining Causes. — These are agents which, 
if powerful, will of themselves be sufficient to determine 
the inflammatory process even in healthy tissues, but which 
will do so with more certainty in parts predisposed. They 
may be arranged as follows : — Direct violence ; the appli- 
cation of irritants ; exposure to heat and cold ; the presence of 
foreign bodies, or of parts deprived of life ; retained concretions 
or excretions; abnormal conditions of the blood, as in rheumatism 
and anaemia, or when containing some irritating ingredient, mor- 
bid or specific virus, or poisonous drug. I think Dr. Burden 
Sanderson simplifies the causes and origin of inflammation very 
much. He says — " With reference to their origin, aU inflam- 
mations may be comprised in two classes — extrinsic and in- 
trinsic. Of these two terms, the former is applicable to all those 
cases in which an injury, either sustained by the affected part 
or inflicted elsewhere, is the obvious cause of the morbid process ; 
the latter to those inflammations which, from the concealment 
of their cause, are commonly called idiopathic. If, however, we 
desire to speak accurately, we must discard this word altogether ; 
for there is no case in which it can be reasonably doubted that 
an injury must have preceded the earliest sign of local disorder, 
however little we may know either of the nature of the agent 
or of the mode of its action. We might advantageously sub- 
stitute for idiopathic either of the words intrinsic or secondary ; 
but inasmuch as there is no channel by which an agent from 
within, i.e., from some other part of the body, could penetrate 
into a tissue, excepting by the blood-vessels or lymphatics, we 
are entitled to use the only word which fully expresses this 
view of the mode of introduction of the material cause, and to 
designate all so-called idiopathic inflammations infective. 

" From what has been said it may be readily understood that 
the primary inflammations naturally affect those parts princi- 



16 INFLAMMATION. 

pally ■whicli are exposed to external influences, while those of 
the other class occur hy preference in parts and organs to which 
there is no access excepting through the circulation. These 
distinctions, however, are not constant, for there are many in- 
stances in which secondary inflammations affect external parts, 
and many others in which internal organs are the seat of 
primary inflammations, as, for example, when nephritis arises 
from exposure to cold. Much more important distinctions, 
however, may be based on a comparison of the structural 
changes which the two processes determine in the tissues 
affected ; or, in other words, on their pathological anatomy. In 
making this comparison, there is one important principle to be 
borne in mind : In all injlammations, the form of the lesion is 
dependent on that of the area of influence of the injury. Thus, 
in those cases of primary inflammation in which it may be 
supposed that an impression received by afferent nerves distri- 
buted to mucous or cutaneous surfaces, is reflected to internal 
organs (as in the case of nephritis from cold, already referred to), 
the area of influence of the injury is wide enough to comprise 
whole organs, and the resulting lesions are of corresponding 
extent. In the strictly local inflammations, the correspondence 
in form between cause and effect is, of course, closer and more 
obvious, the area of a traumatic inflammation being larger than 
that of the injury which produces it, but of exactly similar form. 
As regards infective inflammations, the correspondence is not so 
plain, but the consideration of their pathological anatomy is 
sufiicient to satisfy us that it is equally complete. It is the 
anatomical character of all infective inflammations that the 
lesions to which they give rise are disseminated rather than 
diffused. Particles of matter, of the nature of which we can 
assert nothing, excepting that they are of extreme minuteness, are 
conveyed from a primarily inflamed part to other parts previously 
healthy, and become foci of infective induration or suppuration 
(miliary tubercles, pysemic abscesses), each of which is the pro- 
duct — if one may be allowed the expression — of a single seed." 



VAKIETIES OF INFLAMMATION DUE TO CAUSATION. 

And to quote from the same author on this subject : — 
■ Although if we be careful to distinguish what is essential to 



VAEIETIES OF INFLAMMATION DUE TO CAUSATION. 17 

the process of inflammation, viz., tlie altered state of the vessels, 
from the phenomena which accompany it, and the textural 
germination which it produces, its characters will appear to us 
to present very slight variation, yet the visihle results by which 
it manifests itself differ widely in different cases. It is there- 
fore necessarj'', in order to complete the present subject, to con- 
sider in what degree these differences correspond to differences 
in the causes which produce them. 

" Vesication. — If a hot iron is applied to the skin at a sufficient 
temperature, it at once destroys its vitality, If the temperature 
be a little below that which is necessary to produce this result, 
the blood contained in the vessels coagulates, and the tissue 
eventually dies. At a still lower temperature the skin retains 
its vitality, but blisters are formed at or around the injured part. 

" If the mesentery of a guinea-pig is touched with a heated 
surface, and the effect observed under the microscope, it is found 
that stasis is produced which is co-extensive with the surface of 
contact. It is tolerably certain that in like manner, in vesica- 
tion of the skin by heat, the circulation of the heated part is 
abruptly brought to a standstill. As, outside of the area of 
stagnation, it goes on at first with unabated then with increased 
vigour, while the walls of the capillaries are probably acted 
upon by the heat in such a manner as to render them more 
permeable, we can readily understand how it happens that 
liquor sanguinis is exuded more rapidly and more abundantly 
than in ordinary inflammations. From the researches of Dr. 
Samuel of Konigsberg it seems probable that the effects of 
liquid vesicants agree with those of heat in all the respects 
which have been referred to; so that the peculiarity of the 
mode of action of vesicant agents in general, would seem to lie 
in its suddenness, and in the faculty which they possess of at 
once producing those changes in the capillary wall which in ordi- 
nary inflammation require a longer time and a more gradual 
process for their production. In this way the exudation of 
liquor sanguinis, instead of being deferred until the slowing 
of the circulation has commenced, begins immediately, and, 
favoured by the primary arterial afflux, and the increased intra- 
vascular pressure consequent on the sudden capillary obstruc- 
tion, is so abundant that the liquid collects in blisters. 

" Eelation between inflammation and the reparative process. — 

G 



18 INFLAMMATION. 

When the local injury is so intense as to destroy the vitality of 
the affected part at once, that part becomes surrounded with a 
zone of inflamed tissue, from which it eventually separates, leav- 
ing behind it a granulating surface. To understand this process 
of demarcation and separation, it is in the first place to be borne 
in mind that the exuded liquid contains the fibrine-producing 
elements of the blood, and that contact with dead substance at 
once determines coagulation of all such fibrinogenous liquids. 
Accordingly, the first step in the process of reparative separation 
is the formation, in contact with the dead part, of a more or less 
solid stratum of fibrine, in which stratum the production of new 
capillaries and granulation tissue commences." 



LOCAL SYMPTOMS OF INFLAMMATION. 

Redness. — In the lower animals this symptom can only be seen 
in the white parts of the body, such as the white skin of the 
heels of some horses, and upon the visible mucous membranes. 
It arises from an increased quantity of blood in the part, both 
in the capillaries and in the large vessels ; and when the con- 
gestion is excessive, particularly if it be due to some mechanical 
cause or obstruction, the redness is increased by the passage of 
the red corpuscles through the walls of the capillaries without 
rupture. The corpuscles, in passing through the vessel, become 
constricted in their centre, so as to assume an hour-glass shape. 
This passage of the red corpuscles can be seen in the frog's web 
after ligature of the femoral vein. In some cases the redness 
may be caused by extravasation of blood, but generally it de- 
pends on engorgement. The redness of inflammation is more or 
less vivid ; deepest in the centre, gradually shading off towards 
the edges of the inflamed part, and partly removable by pres- 
sure ; but if extravasation be present, its margin wUl be more 
defined, and the colour is not removable by pressure. 

The aspect of the redness may differ according to various 
circumstances ; if the capQlary networks of the part be uniformly 
distended, the injection will appear as an uniform deep blush; 
if, on the other hand, they are moulded in the form of villi or 
folds of mucous membrane, the surface will have the appearance 
of a pile of red velvet. In fibrous structures the rednese has 
a streaky appearance. The redness does not depend upon the 



LOCAL SYMPTOMS. 19 

formation of new blood-vessels, a process which does not talre 
place tiU the inflammation is much advanced. Staining of the 
tissues with transuded hsematine may occur soon after stasis 
has been established. 

The veterinary practitioner should always carefully distinguish 
between genuine inflammatory redness and that which closely 
resembles it in the dead body, namely, hypostatic redness, which 
depends on mechanical causes or the mode in which death has 
been produced. 

Eedness existing only in a depending part of the body, such 
as the side upon which an animal has lain since its death, with- 
out thickening of the part, must never be looked upon as 
evidence of the inflammatory condition. 

The presence or absence of redness is not of itself a proof of 
the presence or absence of inflammation. Eedness exists with- 
out inflammation : thus we find the visible mucous membranes 
red and injected in many diseases, but no one for a moment 
supposes that these membranes are inflamed. On the other 
hand, absence of redness is no proof that inflammation does not 
exist, for some inflammations, as those of the cornea, of the 
arachnoid membrane, and of articular cartilage, are attended 
with no redness, but rather with opacity, and it is only in con- 
junction with other indications that redness can be regarded as 
a symptom of inflammation. 

Pain. — The pain of inflammation varies much in degree and in 
kind, according to its cause, intensity, and seat. The pain of, 
laminitis, of punctured foot, of open joint, or of inflammation 
of any unyielding fibrous or bony texture, amounts very often to 
extreme agony. The pain of inflamed serous membrane, more 
especially of inflamed pleura, is of a sharp, darting kind, giving rise 
to colicky symptoms. In traumatic peritonitis, on the contrary, 
although the pain may be excessive, the animal does not always 
exhibit it, owing to the prostration which is present. The pain of 
inflamed mucous membrane is dull, or simply an uneasiness not 
amounting to actual pain. But pain is not a constant symptom 
of inflammation, and of inflammation without it the following 
may be enumerated : — Insidious and indolent forms of scrofulous 
inflammation, especially in homed cattle, in which extensive 
disorganizations are often produced without the animal ever 
having manifested any signs of pain; inflammation of a para- 



20 



INFLAMMATION. 



lyzed part, with sloughing, as in the posterior extremities, after 
parturient apoplexy; or that inflammation occurring in the 
foot, pastern, and fetlock of the horse, after neurotomy has been 
performed ; typhoid inflammation of the lungs, where little mdi- 




FiG. 4 shows the immensely enlarged condition of the coronet and pastern, from 
inflammation and gelatinous degeneration, succeeding neurotomy, a, Toe of foot ; 
b, Fetlock pad. 

cation has been shown during life, and it must also be presumed 
that the formation of pulmonary abscesses in glanders is un- 
attended by pain. "We therefore conclude that the absence of 
pain is no indication of the absence of inflammation, and that 
the presence of pain is not impossible without inflammation. 
Of this we have many examples, as in spasmodic colic, where 
pain is intense ; in tetanus, and in cramp of the voluntary 
muscles. One peculiar case came under my immediate know- 
ledge, where pain was present to a most exquisite degree, with- 
out either spasm or inflammation, and where the external iliac 
artery of the near (left) side was plugged by a fibrinous clot 
(embolus). The animal while at rest exhibited nothing unusual, 
but if put to work in the carriage he would not proceed 
500 yards without the limb becoming icy cold; he would 



LOCAL SYMPTOMS. 21 

tlieu groan, break out in sweats upon various parts of the 
skin, would attempt to lie down ; indeed, when taken to his 
stable, he would lie down, roll, and paw, as if suffering from 
spasmodic colic. This occurred again and again ; and upon the 
animal being killed, the condition of the artery was discovered. 

The sudden cessation of pain in violent inflammation is much 
to be dreaded, as it gives the practitioner good reason to suspect 
that the vitality of the part has been lost, from the inflammation 
having gone on to gangrene. 

The situation of pain is not always the seat of the inflam- 
matory action, as in inflammation of the liver the pain is 
sometimes in the off (right) shoulder, as exhibited by distinct 
shoulder lameness. This is termed sympathetic pain, and is 
the only example within my knowledge where this sympa- 
thetic or reflected pain can be demonstrated, although the prac- 
titioner may surmise that this occurs in inflammation of other 
organs. In periodic ophthalmia it may be seen to some extent. 

The Cause of Pain. — This has been ascribed to compression 
of the nerves of the part by congestion of the vessels and 
effusion ; an exaltation of nervous function ; a painful stretch- 
ing of the nerves, arising from distension of their small nutri- 
tious vessels ; or to impression produced on the nervi vasorum 
by the slight dilatation and elongation of the arteries during 
each impulse of the blood. 

In general, the intensity of the pain depends upon the 
firmness and inelasticity of the part affected. Thus the pain 
of laminitis is of a most excruciating character, from the 
inflamed tissues being confined within the horny foot. The 
pain of open joint is also of this nature, from the firmness and 
hardness of the tissues involved; namely, bone, ligaments, 
synovial membrane, &c. Such structures as these, along with 
tendons and faschise, possessing little sensibility during health, 
in disease become extremely sensitive, and the pain in them 
is often of an agonizing character. Dr. Lionel Beale has 
demonstrated that in textures which in health exhibit but 
slight sensitiveness, and become eminently so when inflamed, 
there is a very great increase in the germinal matter which 
they contain, and that tbis often proceeds to such an extent 
during inflammation that the ramifications of the nerves appear 
as lines of masses of germinal matter ; so that in tissues 



22 INFLAMMATION. 

■whicli thus Lecome highly seusitive during inflammation the 
feeling of pain must he due to the increase of germinal matter 
of the nerves, as well as that of other tissues. Muscmar 
and other softer structures, though endowed with much sensi- 
tiveness during health, are not nearly so painful in inllamma- 
tion. This arises from their yielding nature, giving way and 
allowing free swelling of the part, which in most cases seems 
to relieve pain. The veterinarian has a good example of this 
in lymphangitis, the pain and lameness of which seem to sub- 
side as the swelling of the parts appears. In the treatment 
this should be borne in mind, as remedies that promote swell- 
ing (fomentations) afford very marked relief. 

Swelling. — The swelling of inflammation depends upon — 1st. 
The congestion of the vessels ; arid 2d. The exudation of liquor 
sanguinis and the diapedesis of corpuscles into the tissues. 

Swelling of an external inflamed part may be looked upon — 
except in the case of the articulations, where it is, when very 
great, indicative of ulceration — as a favourable sign, its occur- 
rence often affording relief. But when it occurs in the organs 
essential to life, such as the parenchyma of the lungs, or upon 
the glottis, its presence may soon put an end to the life of the 
animal. Swelling is not always an indication of inflammatory 
action ; the swellings of dropsy, anasarca, and of purpura and 
scarlatina, are very different from those of inflammation. The* 
swelling of purpura is very characteristic, terminating abruptly,, 
superiorly, as if a cord had been drawn around the limb; 
the swelling of anasarca will be found to be most bulky at 
its most depending part. Tumours are also examples of swell- 
ing without inflammation ; cartilage, which is non-vascular, 
swells by its cells taking up more matter, and assuming the 
form of large round corpuscles. In proportion as they take 
up this matter, they enlarge in all directions, often forming 
spots or protuberances on the surface of the articulation, as may 
be seen in navicular lameness. 

Heat. — The temperature of the inflamed part seems to be con- 
siderably increased, affecting the sensations of the observer as 
well as of the sufferer ; hence the name " inflammatio," a burn- 
ing. But this increase of heat is not so decided as one would 
imagine, and the experiments of Hunter go to prove that the 
difference, in most cases, is not more than one degree; and, 



LOCAL SYMPTOMS. 23 

according to some observers, it seems doubtful whether the 
heat of the inflamed part is even higher than that of the other 
parts of the hody. The greatest rise in the temperature is found 
where the inflamed part is far removed from the centre of cir- 
culation, and where the natural temperature is several degrees 
below that of the blood at the heart, as in the feet of our 
patients; and it is also found that in parts remote from the 
centre of circulation the heat is most distressing. 

The sense of heat which the patient experiences must be partly 
due to the increased sensibility of the inflamed part, and also to 
the fact that the functions of the sensory nerves are increased 
and perverted. The greatest degree of heat has been found to 
exist in rinderpest, and this was not due to any inflammation 
of the part, but to the rapidity of the textural changes that 
took place in that plague. In this disease the highest record 
made by me was 109°. The highest temperature recorded by 
writers on human medicine is 11 Of"; this was in tetanus, which 
is not an inflammatory disease. 

Some late experiments upon the production of increased heat 
in a part inflamed may be interesting to the reader. 

The experiments of Mr. Simon, corroborated by those of M. 
0. Weber, go to prove that inflammation does actually cause 
a local production of heat, for the application of a thermo- 
electric needle showed (1st.) that the blood passing to an in- 
flamed part is less warm than that part itself; (2d.) that the 
venous blood returning from an inflamed part is warmer than 
the arterial blood supplying it, though less warm than the focus 
of inflammation; and (3d.) that the venous blood returning 
from an inflamed limb is warmer than the corresponding current 
on the opposite side of the body. 

The subject has been taken up by MM. Jacobson and Bern- 
hardt; and the results of theii- investigations are opposed to the 
above, and corroborative of those of Hunter. They excited pleurisy 
of one side, or general inflammation of the peritoneal cavity in 
rabbits, by injecting dilute acetic acid or caustic ammonia ; and 
when inflammation was established, they compared the tem- 
perature of the inflamed serous sacs with that of others, or 
with the blood in the right or left ventricles of the heart. In 
a preliminary set of experiments they discovered that great 
exactness was obtainable in ascertaining the temperature of 



24 INFLAMMATION. 

internal parts by the insertion of the thermo-electric needle, 
and that, as a general rule, the pleural cavities were from about 
one-tenth to one-fifth of a degree per cent, cooler than the peri- 
toneal cavity, and from one-fifth to one-half of a degree cooler 
than the left side of the heart. It was, therefore, clear that, 
if a temperature of more than one-half a degree per cent, was 
present after inflammation had been set up, it could not be 
due to the blood current, but must have arisen from some 
local and independent source of heat. But the results of 
experiments showed that, so far from any augmentation, there 
was a distinct depression of temperature on the inflamed side, 
amounting in one case, when the pleural sac was filled with 
fibrinous fluid, to as much as one-half of a degree per cent, less 
than that of the peritoneum, and about one-third of a degree 
below that of the opposite pleura, and more than one-half of a 
degree cooler than that of the left heart. Again, in peritonitis 
the temperature was less than that of the left heart by as 
much as two-thirds of a degree per cent., and in one case it 
was 1 • 1° per cent, (equal to 2° Fahr.) below that of the blood 
in the left ventricle. 

To settle this uncertainty, experiments have been instituted, 
which have led to the following conclusions : — 1st. That arterial 
blood supplied to an inflamed limb is less warm than the seat of 
inflammation; 2d. That the venous blood returning from an 
inflamed limb, though less warm than the focus of inflainmation, 
is warmer than the arterial blood supplied to it ; and Sd. That the 
venous blood returning from an inflamed limb is warmer than 
the corresponding current on the opposite side of the body. On 
the evidence of these experiments, which were made on three 
dogs with compound fracture of the leg, Mr. Simon ventures to 
say that the inflamed part is no mere recipient of heat, but is 
itself actively calorific; and that in proportion to its heated 
venous outflow the temperature of the common mass of circu- 
lating blood is necessarily raised; and that the local disorder 
represents an influence which tends to diffusion throughout the 
body, and thus be an important cause of inflammatory fever. 

Impairment of Function. — Perversion or impairment of the 
functional properties of a part under inflammation is a very 
common, indeed almost a constant, accompaniment of its various 
stages. lu the first stage it may be increased, as may be 



CHEONIC INFLAMMATION. 25 

witnessed in the delirium of the first stage cf phrenitis, and 
almost suspended during the comatose or later stage. In 
enteritis it is often found that the howels will act excitedly, 
small quantities of fEEces being passed very frequently at the 
commencement of that disease, but at a later stage their action 
will be entirely suspended. 

In inflammation of the muscles, again, we find that there is 
almost total loss of their proper contractile power, and that 
what remains of it is brought into action with difficulty and 
pain ; showing that though their functional activity is lost, their 
sensibility is highly exalted. 



CHRONIC INFLAMMATION. 

Inflammations, according to the severity of their causes, and 
duration of their action, manifest certain alterations in their 
progress and termination, and the terms acute, sub-acute, and 
chronic have reference to the periods of the duration of the 
inflammation, or the rapidity or slowness of its course. 

In chronic inflammation the action of the irritant, though less 
immediate and severe, is much more prolonged, and has a greater 
tendency to excite the formation of an abundance of tissue, 
which, though less highly organized than the normal, yet is not 
so prone to undergo those retrogressive changes which charac- 
terise the exudates of acute inflammation. 

Whilst the more highly vascular organs are by no means 
exempt from chronic inflammation, it is found that the less or 
non-vascular tissues more commonly undergo those changes 
which characterise it ; changes due either to the nature of the 
irritant, the vital tone of the tissue irritated, or to the strength 
of the cause being insufficient to excite the more acute and 
rapid inflammation. 

Chronic inflammation may run its course independently of the 
acute ; it may also supervene or precede it ; but generally the 
milder it is at the outset, and the more prolonged in its course, 
the more highly organized and more permanent will be its pro- 
ducts. From this it will be gathered that chronic inflammation 
— unimportant perhaps when not located in vital organs — 
becomes exceedingly grave when involving organs or tissues 
essential to life, inasmuch as the inflammatory new formation 



26 INFLAMMATION. 

may so press upon or even destroy the structure of an organ as 
to render it incapable of performing its function. 

Of this we have examples in consolidation of the lungs, 
cirrhosis of the liver, &c. 

There are some chronic inflammations which are essentially 
destructive to the tissue which they involve, and in which there 
is no tendency to the formation of new tissue in the inflamed 
part itself — as, for example, in inflammation of articular cartil- 
age ; but even in these, with but few exceptions, there is an 
increased formation of iibrous, and even more highly organized 
tissue, i.e., bone, in close proximity to the focus of inflammation. 

TERMINATIONS OF INFLAMMATION. 

Many pathologists are of opinion that there are great objec- 
tions to the expression used here, and that what are regarded 
as terminations are conditions co-existent with the various 
stages of inflammation. Some have even gone so far as to say 
that resolution is not a termination ; but we must at least retain 
that term, as it seems the only termination. The words results, 
or events, are now used instead of terminations ; and, retaining 
resolution as a termination, these are — Effusion of Serum, Exu- 
dcdion of Coagulable Lymph, Suppuration, Ulceration, Gangre'Mi 
and Sphacelus. 

KESOLUTION. 

This is said to occur when the symptoms gradually subside, 
and when there is a cessation of the transudation of the fluid 
part of the blood from the vessels ; or, in other words, a resto- 
ration of the nutritive functions of the part into their normal 
condition, and the absorption of the substance contained in the 
tissue. This subsidence of inflammation may be sudden, when 
it is called delitescence; or it may be gradual, when it is 
called resolution; or it may be sudden, and the inflammation 
may as suddenly appear in another part of the body, and then 
metastasis is said to have taken place. 

Eesolution occurs in two ways :—lst. The sudden cessation of 
the irritation, delitescence, and removal of the exuded materials 
before coagulation or solidification has been effected. In this 
process the veins and lymphatics lake up the exudate in its 



TERMINATIONS OF INFLAMMATION. 27 

normal fluid condition, as it occurs in ordinary serum -when 
blood is drawn from the body before the fibrine has coagulated. 

2d. The exudation is more complete, the exuded lymph is 
consolidated, or even transformed into a low form of fibrous 
tissue, surrounded by and soaked in much serosity. At this 
point its organization is arrested, the contents of the cells con- 
verted into fatty granules, the cell walls break down, the granules 
escape into the surrounding fluid (serosity), forming a fluid resem- 
bling chyle — called pathological milk by Virchow. In this condi- 
tion it is absorbed into the circulation, and after undergoing other 
transformations whilst mixed with the blood — converted into 
urea, hippurates, ammonia, carbonic acid, &c. — is finally ejected 
from the system by the excretory organs, leaving the inflamed 
part in its original condition, or perhaps slightly altered. 

The termination which has been called " Adhesion " is another 
method by which the exudate is disposed of, and presents a more 
complete and higher organization of the lymph than the former. 
In this process the cells, instead of undergoing fatty degenera- 
tion, become developed into a form of fibrous tissue, which in 
the course of time becomes vascular by the formation of new 
blood-vessels within its substance ; and whilst organization is 
going on in the tissue, the surrounding serum is absorbed, 
leaving the new formation as part of the economy, remain- 
ing so, as in the adhesions of pleuritis, &c., throughout the 
animal's life. 

The formation of the new blood-vessels is very interesting, 
and is supposed to be effected as follows : — Coincident with the 
structural development of the cells and intermediate substance 
into connective tissue, new blood-vessels are formed by outgrowths 
from the walls of the original vessels of the surrounding parts. 
These outgrowths first appear as slight pouches on several 
original vessels ; these pouches or dilatations first present them- 
selves on one point of a vessel, then on another, as if its 
walls yielded a little; they gradually extend themselves as 
blind canals from the original vessels, directing their course 
towards the edge or surface of the new material, and are 
crowded with blood globules, which are pushed into them from 
the main stream. StiU extending, they converge and meet ; 
the partition wall that is at first formed by the meeting of their 
closed ends clears away, and a perfect arched tube is thus made, 



28 INFLAMMATION. 

tlirough which the blood, diverging from the main stream, and 
then rejoining it, may be continuously propelled : or a delicate 
threadlike process shoots from a vessel, and becomes connected 
with corresponding shoots from other vessels. These fine pro- 
cesses widen out, become tubular, and their cavities form canals 
continuous with those of the parent vessels. When the new 
blood-vessel has begun to project it sometimes bursts ; the blood- 
globules that issue from the ruptured pouch collect in an un- 
certain mass within the tissue like a mere ecchymosis, but before 
long they manifest a definite direction ; and the cluster bends 
towards the line in which the new blood-vessel might have 
formed, and opens into a portion of the arch, or into some 
adjacent vessel. For this mode of formation from vessels the 
name of channelling seems appropriate, for it appears certain 
that the blood-globules here make their way in the parenchyma 
of the tissue unconfined by membranous walls. The new vessels 
possess a very simple structure, their walls being a thin mem- 
brane with imbedded nuclei. — (Viechow, Paget.) 

Effusion differs from the so-called exudation of lymph in 
the fact that it occurs from the surface of serous membranes, 
blisters on the skin, or in a very loose areolar tissue, where the 
process of perverted nutrition is of the most rapid kind. 

The fluid found in serous cavities and in serous abscesses 
partakes of the general characters of the serum of the blood 
slightly modified, being of a higher specific gravity and con- 
taining more albumen, with more or less fibrine. Many speci- 
mens of the effusion found in pleuritis, for example, contain 
fibrine in an imperfectly developed condition — fibrine which 
does not coagulate until it is exposed to the atmosphere. 

Now, if the fibrine were transuded through the walls of the 
vessels, it would in all cases coagulate within the body; but 
when, owing to the inflammation being near or upon the surface, 
or in very loose areolar tissue, the transformation of the transuded 
material takes place rapidly, and hence imperfectly — that is to 
say, when the fluid sweats through the walls of the cells in 
an imperfectly developed condition, or, when occurring upon 
a serous membrane (it is also the case in a mucous membrane), 
the epithelial scales are rapidly thrown off, along with the fluid 
they secrete. 

In many effusions we find completely developed fibrine 



KESOLUTION. 29 

floating in the liquid, and often forming bands of adhesion 
between the opposing surfaces of the inflamed membrane. 

In every instance of undoubted pleuritis, effusion of serum 
takes place; and it is ridiculous to hear some speak of the 
differences that are observable in the symptoms when this occurs, 
and of the great danger to be apprehended. The effusion is part 
and parcel of the process of inflammation from almost the outset, 
and the only danger is owing either to the constitution of the 
animal being bad, or the treatment irrational, or the attack of 
more than ordinary severity, that the effusion may become 
excessive, and cause death by suffocation. 

Serous efi'usion is sometimes the result of mechanical con- 
gestion, as witnessed in oedema of the extremities, in ascites, 
irom disease of the liver, spleen, or heart, but this is totally 
unconnected with inflammation ; in such instances the fluid is 
clear, and generally contains but little fibrine, or any substance 
that coagulates upon exposure to the air. 

The formation of a non -coagulating effusion in the various 
cavities is very propitious; for so long as it remains liquid, 
absorption may still ensue without its undergoing any ulterior 
changes when the inflammation subsides. The subsidence of 
the inflammatory action, however, is necessary, for, from what 
has been already said, there is impairment of function, and 
absorption does not readily take place. 

It has been shown by Beale, Simon, and others, that there 
are two essential characteristics of inflammatory effusion: — 
Isi. It contains certain ingredients in larger proportion than that 
in which they exist in the blood — excess of chloride of sodium, 
of phosphates, and albumen ; and 2d., organic germs find in it a 
suitable place for growth. 

BLOOD EFFUSION, OK EXTEATASATIOS. 

This occurs chiefly from rupture of new blood-vessels de- 
veloped in the newly-formed material which has just become 
vascular. — (Eokitansky.) But we find it when there has been 
no time for the formation of such new vessels, namely, at the 
very commencement of an acute inflammation of the substance 
of the lungs ; but this is rare, and betokens either a very bad 
consDitution, or that the inflammation is due to a very malignaui 



oD INFLAMMATION. 

epizootic influence, or that it arises from that condition of blood 
observable in purpura. These haemorrhages must not, however, 
be confounded with blood-staining of the part through the 
oozing of some of the colouring matter of the blood. The 
natural colour of the inflammatory new formations is greyish or 
yellowish- white (straw colour very often) ; and even when they 
contain blood-vessels, this opacity prevents their having any 
uniform tinge of redness when they are recent. (Example — 
Surface of lung in pleuro-pneumonia.) When they present a 
tinge of redness, it is either because of haemorrhage into them, 
or because they have imbibed the dissolved colouring matter of 
the blood (heematodine) ; and when this imbibition happens 
during life, or soon after death, it is important, as indicating an 
ill-conditioned state of the blood, in which the colouring matter 
of the corpuscles becomes unnaturally soluble. 



CHAPTER 11. 

TEEMiNATioxs OF INFLAMMATION — Continued. 

SUPPURATION ACUTE ABSCESS — DIFFnSE SUPPURATION — SUPERFICIAL 

SUPPURATION COMPARISON BETWEEN MUCUS, EPITHELIUM, AND 

PUS PYOGENIC FETER.OR STRANGLES PYEMIA RE-ABSORPTION 

OF PUS FORMATION OF SINUSES ULCERATION VARIETIES AND 

TREATMENT OF ULCERS MORTIFICATION. 

The formation of pus is termed suppuration, and it takes place 
in three distinct ways — (1.) circumscribed; (2.) diffused; and 
(3.) superficial suppurations. 

As an example of the first or circumscribed form, I shall take 
what is called an abscess or phlegmon, in which the suppura- 
tion is enclosed in a cavity (as in the abscess of strangles) 
whose walls are composed of areolar tissue. In the first stage, 
the ceUs of the connective or areolar tissue are charged with 
the material (lymph) formed by them during the first stage of 
the inflammation; there is an enlargement of the cells, their 
nuclei divide, and for some time multiply excessively. This 
is soon followed by division of the cells themselves, and round 
about the irritated or inflamed parts, where single cells formerly 
lay, pairs or groups of cells are subsequently found, out of 
which a new formation (connective tissue) grows. In the in- 
terior of this growth, where the cells were at an early period 
abundantly filled with nuclei, numberless little cells soon ap- 
pear, which at first stiU preserve the direction and forms of the 
previous connective tissue corpuscles. 

These accumulations of little cells occur somewhat later, as 
diffuse infiltrations of roundish masses encircled by the inter- 



32 



TERMINATIONS OF INFLAMMATION. 




mediate tissue, which continuaJly liquefies and becomes more 

and more scanty as the pro- 



liferation of the cells extends. 
It is held that this liquefaction 
is of a chemical nature; the 
intermediate substance (which 
is of a glutinous nature) be- 
comes converted ultimately into 
an albuminous fluid, and is ren- 
FiG. 5. — Purulent granulations from dered liquid. We thus see that 

the subcutaneous tissue of a rabbit round . -■ . jr,„„„,, 

about a ligature, a. Connective tissue puS IS not derived Irom any 

corpuscles, b. Enlargement of the cor- effusion, but that it is formed 

puscles, with division of the nuclei, c. ■ i i • j.i. 

Division of the cells (granulations), d. by Vital changes in the germs 

Development of the pus corpuscles.— ^f ^Jjg tisSUe, and that, by a 

(ViECHOW.) ,.„ . „ , 

slight modification oi the same 
process, new connective tissue is formed. The outmost layer 

of the intercellular tissue is 
often long preserved, whilst 
all its deeper parts are already 
filled with pus corpuscles, 
or are converted into an 
abscess; at last the surface 
gives way, or, without giving 
way, is directly transformed 
into a soft diffluent mass. — 

(VlECHOW ) 

The pus itself was for- 
merly thought to have solvent 
properties, and that by this 
power it was enabled to find its way to the surface, but experi- 
ments have proved this to be incorrect. Bones have been 
placed in cavities full of pus, and left there for weeks, and 
when they were afterwards weighed, they have, if ^anything, 
become heavier, through the absorption of fluid matters, but no 
softening has been produced, except that caused by decomposi- 
tion. How far the tissue is destroyed by solution chiefly de- 
pends upon the question whether the substance that surrounds 
the young cells becomes completely fluid. If it retains a cer- 
tain degree of consistence, the process is confined to the pro- 
duction of granulations, and these may as well proceed from a 




Fio. 6.- 



ExAHPLES OF Cells. 
a. Young cells. 



6 and c. 
Connecting tissue cells ; and d. Pus cell, 
all derived from a. 



SUPPUEA.TION. 



33 



surface whose contiimity is perfect, as from one in which there 
is a breach. In every case granulations arise out of the tissue, 
a!nd it is not essential there should be loss of substance ; they 
are found upon bone without any loss of substance having pre- 
ceded them. They are found also in direct contact with the 
cutis under intact epidermis, and with mucous membranes ; and 
only in proportion as they become developed do the mucous 
membranes lose their normal character. 

Well-formed, perfectly ela- 
borated, healthy pus is a smooth, 
rather greasy, sometimes viscid, 
yellowish-white, or cream-col- 
oured substance, of a higher 
specific gravity than water, aver- 
aging generally about 1-030 
having little or no smell, and of 
an alkaline reaction. Microsco- 

picaUy it is found to consist of *•. Containing" pigment gramUes. 300 
^ ■^ diameters. — (Virohow.) 

certain essential constituents, 

J' 

namely, pus corpuscles; which 
measure about ^sVo to ^^^ 
of an inch in diameter, are pel- 
lucid, filled with semi-fluid 
albuminous contents, and some- 
times containing a few minute 
oil globules. Along with the 
pus cells floating in the clear 
liquor puris are often seen 
minute clear particles, which 
seem to have some relation, as 
nuclei or rudiments of the cells. 



6 



Fig. 7.— Cells from fresh catarrhal 
sputa. A. Pus corpuscles, a. Quite fresh. 
h. When treated with acetic acid. Within 
the membrane the contents have cleared 
up, and three little nuclei are seen. 
B. Mucus corpuscles, a. A simple one. 



(g) @ @ <^@ 



© @ (© sa 0^ 

^ ff^ ©0 



o"o 




'Fig. 8. — A. Pus corpuscles, a, Fresh. 
b. After the addition of a little water. 
c-e. After treatment with acetic acid, 
the contents cleared up, the nuclei 
which were in process of division, or 
already divided, visible at e, with a slight 
depression on their surface. £. Nuclei 

These minute particles are not of pus corpuscles, a. Simple nucleus 

, „ . , . with nucleoli, b. Incipient division, with 

more tnan yg-.-jj-iyo OI an men m depressions* on the surface of the nuclei. 

size. These two solid COnsti- <■■ Progressive bi-partition. d. Tri-par- 

n ■ ] tition. C. Pus corpuscles m their natu- 

tuents float in a fluid or serum, ral position with regard to one another. 

caRed the liquor puris, and the 600 diameters. —(Vibchow.) 

shape of the cells depends on * By many heia to te nucleolL 

the density of this liquor puris. Sometimes a distinct, circular, 
dark-edged nucleus may be seen in the paler corpuscles, and 
sometimes two or even three particles, like a divided nucleus. 

D 



34 TERMINATIONS OF INFLAMMATION. 

These, then, are the component parts of good, healthy, or 
laudable pus, showing a benign form of inflammation, and 
that the disease is going on regularly and promises a for- 
tunate issue. When, however, the process deviates from the 
usual course in an animal otherwise healthy, variations are 
found in the cells, with multiform mixtures of withered cells ; 
molecular and fatty matter; escaped and shrivelled nuclei, 
blood corpuscles, and fragments of fibrogenous material; the 
liquor puris is thin, liquid, or watery, and the pus is then 
said to be ichorous. When the colouring matter of the blood 
is mixed with it, it is called sanies, or sanious pus. 

Many chemical and vital changes are found to bring about 
a decomposition in pus while yet in contact with living parts, 
although it is probable that germs in the atmosphere, or gases 
formed within the body, may have to do with the change ; but 
phosphuretted and sulphuretted hydrogen and ammonia will be 
found frequently developed in abscesses, especially if the pus be 
in contact with bone, or near the alimentary canal, or in the foot : 
the smell is then most offensive ; it is then called fmtid pios. 
Pus may also contain certain specific properties ; that is to say, 
it may be impregnated with certain specific poisons, as that of 
glanders, variola, &c. 

Healthy or laudable pus has no smell, except that peculiar 
to the animal in which it may exist ; it has an alkaline 
reaction when freshly drawn from an abscess, but it readily 
becomes acid from the generation of what is supposed to be 
lactic acid. 

It will be gathered from the foregoing remarks that the 
boundary or wall of an abscess consists of newly formed areolar 
tissue, which has maintained the firmness and solidity of the 
part by activity of nuclear growth. There is sometimes found 
to be a thin, opaque, yellowish-white layer, easily detached, 
separating the suppuration from the denser part. This has 
been called pijogenic membrane, from the supposition that its 
function is to secrete the pus ; whereas the cells of the denser 
part are — by prematura and continuous development — ^growing 
into pus cells ; that is to say, there is no secretion of pus by 
any membrane, but a continual formation of it by proliferation 
of the cells proper to the part. 

When suppuration takes place in the cavities of the body, it 



SUPPUEATION. 35 

is still circumscrilied ; however, it is not called an abscess, but 
" purulent effusion." 

Abscesses are occasionally found to exist without the usual 
signs of inflammation ; they are then called " cold abscesses ; " 
and when slowly formed, chronic or old abscesses. 

Abscesses are divided into acute and chronic. 



ACUTE ABSCESS. 

Symptoms. — Symptoms of inflammation precede the sup- 
puration; there is heat, pain, and swelling in the part, with 
more or less symptomatic fever ; for a time the pain increases, 
and changes to a throbbing character. The swelling becomes 
harder from increased exudation, and when the abscess is deeply 
situated, there is some oedema of the surrounding areolar tissue. 
Concomitant with these symptoms, a tendency to rigor or 
shivering may be observed by the staring coat, or actual rigors 
of a severe character may occur. 

In the centre of the swelling pus is formed, and around this 
a layer of condensed plastic lymph, being the boundary or 
cyst of the abscess. The quantity of pus increases, and by its 
presence causes the absorption of the boundary of the abscess, 
more particularly of that portion nearest to the free surfaces of 
the body, generally the skin. The swelling becomes soft in the 
middle, but continues hard at the base, and cedematous at a 
oreater distance. The next change is the elevation of the centre 
into a prominent hairless spot. This is called the pointing of 
the abscess. 

In general, some time before the abscess points, fluctuation 
is discoverable, particularly if it is superficially situated; but 
if deep-seated, and where the superimposed structures are still 
tense and thick, the quantity of pus but scanty, the perception 
of fluid is obscure; it becomes, however, more and more dis- 
tinct as the tissues external to it become thinner. 

A noticeable feature in the pointing of an abscess in the 
lower animals is the removal of the hairs, these falling off and 
leavin" a bare spot on the most prominent part of the swelling. 
This is accounted for by the absorption of the skin and destruc- 
tion of the hair follicles, which take place before the abscess 
finally bursts. When the collection of matter is small, or 



36 TERMINATIONS OF INFLAMMATION. 

thickly covered, a very nice-practised sense of touch, the tactus 
eruditvs, is requisite for detecting its presence; but if the 
abscess be large or superficial, simple palpation at one point is 
sufficient to detect it. 

In feeling for fluctuation, the points of the fingers of one 
hand are placed on the dependent part of the abscess, whilst 
with the fingers of the other hand the upper part of the swell- 
ing is gently pressed or tapped, when the undulations of the pus 
will be distinctly felt. 

In the treatment of acute abscess soothing remedies are the 
most useful, and of these heat and moisture are the best, as 
they not only soothe, but promote the formation and growth 
of pus. They should consist of warm fomentations and 
poultices, and if the pain be excessive, anodynes may be given 
internally and applied locally. As soon as pus is formed, a free 
incision should be made into the abscess, to allow its ready 
escape ; then a warm poultice is to be applied for a few days, 
but a long-continued apphcation of poultices is apt to give 
rise to weak action in the cavity of the abscess. There is no 
necessity for violently squeezing the abscess after it is opened, 
nor to introduce pledgets of tow into it, as practised by some. 
After the removal of the poultice all that is necessary is to keep 
the parts clean, and apply a weak solution of carbolic acid to 
the lips of the wound. Generally, abscesses should be opened ; 
they should always be opened when too deep-seated to point ; 
but abscesses in the neighbourhood of a joint should be treated 
with great caution, and, as a rule, allowed to burst spontaneously. 
The abscess of simple strangles should not, in my opinion, be 
opened, but allowed to run its natural course. 

The best instrument for opening an abscess is Syme's abscess 
knife, the point to be inserted, and the opening so made enlarged 
as the knife is withdrawn. 



DIFFUSE SUPPUEATION. 

We have examples of this in purulent infiltration of an organ, 
as in the lungs in acute glanders. The inflammation extends 
through a wide extent of tissue, and the boundaries of the dis- 
ease are ill defined. The development and growth of the pus 
cells is exceedingly rapid, the tissue beitig a.s if soaked in pus. 



DIFFUSE SUPPURATION. 37 

and should the animal not die quickly, large sloughs or death 
of portions of structure may take place. 

formation of pus, occurring in loose texture — the popliteal 
space, poU, withers — may cause infiltration by gravity, thus 
leading to a secondary destruction of tissue, and the formation 
of sinuses. 

The progress of purulent effusion is probably not dissimilar 
to that of the phlegmonous abscess, but the iaflammation is of 
a different type, and all the processes less complete. Thus we 
find no barrier of condensed tissue to circumscribe the abscess, 
or limit the pus. The process of suppuration is less per- 
fect, so that the pus contains shreds or even large portions 
of mortified and loose connective tissue. There is no vital 
transformation into a fluid albuminous substance here, as in a 
healthy abscess. The pus is also thinner, containing a large 
portion of liquor puris, and also sometimes flakes of lymph. 
There is no pointing, as in true abscess, for the pus passes 
I'eadily from its original seat by gravitation towards the most 
depending position, presenting a soft, broad surface, without any 
indication of pointing. I have often seen these collections of 
pus not only in the lungs of glandered horses, but in the lungs 
of horned cattle, that have survived and apparently recovered 
from pleuro-pneumonia. 

Wounds on the gluteal region, more especially near the 
tuberosity of the ischium, are apt to cause very extensive infil- 
tration of pus throughout the inter-muscular areolar tissue of 
the thigh. Yery often, after an apparent recovery from a 
wound in this region, the lower part of the thigh wiU begin to 
swell, and on examination the enlargement will be found to con- 
tain a large quantity of pus, extending, perhaps, from immediately 
above the hock to the groin, the pus having burrowed from the 
wound above, and by gravitation forced its way down among the 
tendons of the various muscles. Sometimes there are direct 
signs of pointing, sometimes not. All such collections, wherever 
situated, should be removed by puncturing the lowest part of 
the swelling. 

SUPERFICIAL SUPPUEATION 

May be witnessed in inflammation of mucous membranes and 
the skin, and the growth of pus can be clearly traced where 



33 TERMINATIONS OF INFLAMMATION. 

columnar and stratified epithelium exists. I shall here quote 
from Virchow, who says :— " If you follow the development of 
pus upon the skin, when the process is unaccompanied by 
ulceration, you will constantly see that the suppuration pro- 
ceeds from the rete malphigi. It consists in a growth and 
development of new cells in this part of the cuticle. In pro- 
portion as these cells proliferate, a separation of the harder 
layers of the epidermis ensues, and they are lifted up in the 
form of a vesicle or pustule. The place where the suppuration 
chiefly occurs corresponds to the superficial layers of the rete, 
which is already in process of conversion into epithelium ; if 
the membrane of the vesicle be stripped of, this layer usually 
adheres to the epidermis, and is stripped off with it. In the 
deeper layers we may watch how the cellular elements, which 
originally have only single nuclei, divide, and how their nuclei 
become more abundant, and single cells have their places taken 
by several, which in their turn again provide themselves with 
dividing nuclei. Here, too, people have generally helped them- 
selves out of the difficulty by assuming that, in the first in- 
stance, an exudation was poured out, which produced the pus 
in itself, and this is the reason why most investigators into the 
development of pus especially selected fluids which were secreted 
from injured surfaces. It was very conceivable that, as long 
as no doubts were entertained with regard to discontinuous 
formation of cells, the young cells should, without more in- 
quiry, be looked upon as independent new formations; and 
that the notion should be entertained that germs arose in the 
exuded fluids, and gradually becoming more numerous, supplied 
the pus. But the matter stands really thus : — The longer the 
suppuration lasts, the more certainly is one series of cells after 
the other in the rete involved in the process of proliferation, 
and whilst the vesicle is rising up, the quantit)'- of the cells 
which grow into its cavity is constantly becoming greater. 
When a variolous pustule forms, there is at first only a drop of 
clear fluid present, but nothing arises in it ; it only loosens the 
neighbouring parts of the rete malphigi. 

"Precisely the same is the case with mucous membranes. 
There is not a single mucous membrane which may not, under 
certain circumstances, furnish puriform elements. But here, 
too, a certain difference always presents itself. A mucous 



SUPERFICIAL SUPPUEATION. 39 

membrane is all the more in a condition to produce pus without 
ulceration the more completely the epithelium which it possesses 
is stratified. All mucous membranes with a single layer of 
cylindrical epithelium (intestines) are much less adapted to the 
production of pus ; that which is produced on them, even though 
it has quite the appearance of pus, frequently turns out, upon 
close examination, to be only epithelium. The intestinal 
mucous membrane, especially that of the small intestines, 
scarcely ever produces pus without ulceration. The mucous 
membrane of the uterus, and of the fallopian tubes, though it 
is frequently covered with a thick mass of quite a puriform 
appearance, almost always secretes epithelial cells only ; whilst 
on other mucous membranes, on that of the urethra, for example, 
we see enormous quantities of pus secreted, as in gonorrhoea, 
without even the slightest ulceration being present on the 
surface. This depends essentially upon the presence of several 
strata of cells, the upper forming a kind of protection to the 
deeper ones, of which the proliferation is thus for a time 
secured. Tlie pus is at last either borne away by the production 
of new masses of pus beneath it, or there occurs simultaneously 
a transudation of fluid, which removes the pus cells from the 
surface, just as in the secretion of semen the epithelial elements 
of the seminal tubes furnish the spermatozoa, and, in addition, 
a fluid which sweeps them away. But the spermatozoa do not 
arise in this fluid ; this is only the vehicle for their onward 
movement. In this manner we frequently see fluid exude on 
the surface of the body without our being able to regard it as 
a cystoblastema. If a proliferation of epithelium simultaneously 
takes place upon the surface, the elements detached by the 
transuded fluid will also be found to consist of nothing but 
proliferating epithelium." 

COMPAEISON BETWEEN MUCUS, EPITHELIUM, AND PUS. 

If now pus, mucus, and epithelial cells be compared with one 
another, it appears that there certainly does exist a series of 
transitional forms or intermediate stages between pus corpuscles 
and the ordinary epithelial structures. By the side of perfectly 
formed pus corpuscles provided with several nuclei are very com- 
monly found somewhat larger, round, granular cells with single 



40 TERMINATIONS OF INFLAMMATION. 

nuclei, tie so-called mucus corpuscle. A little further on we see 
perhaps still larger cells of a typical form, and with single large 
nuclei, and these we call epithelial cells. But the epithelial cells 
are flat, angular, or cylindrical ; whilst mucus and pus corpuscles, 
under all circumstances, remain round. Even from this circum- 
stance may be derived an explanation of the fact that, whilst 
the epithelial cells which cover and are in close opposition to 
one another, acquire a certain firmness of cohesion, mucus and 
pus corpuscles, which lie but loosely one against the other, and 
are of a spherical shape, retain a great degree of mobility, 
and are easily displaced. It has been said that mucus cor- 
puscles are nothing more than young epithelium. Another 
step, and pus corpuscles woidd be nothing more than young 
mucus corpuscles. This is a somewhat erroneous notion. It 
cannot be maintained that a cell which, up to the point when 
it becomes a so-called mucus corpuscle has preserved its form 
as a spherical body, is still in a condition to assume the typical 
form of the epithelium, which ought to exist in the part ; and 
just as little can it be said that a pus corpuscle, after it has 
developed itself in the regular manner, is capable of again 
entering upon a course of development calculated to produce 
a relatively permanent element of the body. The cells in which 
the development of epithelial, mucus, and pus cells originate 
are young forms, but they are not pus corpuscles. In pus, 
every new cell at a very early period sets about dividing its 
nucleus. After a short time the division of the nucleus reaches 
a high pitch without any further growth on the part of the 
cell. In mucus, the cells are wont merely to grow, and in 
some instances to become very large; but they do not pass 
certain limits, and, above all, they do not assume any typical 
form. In epithelium, on the contrary, the elements begin 
even at a very early period to assume their peculiar form; 
for " what is to become a hook right early gets a crook." The 
very youngest elements, however, which are found in pathological 
conditions, cannot be called epithelial cells, or at least they have 
as yet nothing typical about them, but are indifferent formative 
cells which might also become mucus or pus corpuscles. 

Pus, umcus, and epithelial cells are therefore pathologically 
equivalent parts, which may indeed replace one another, but 
cannot perform each other's functions. 



COMPARISON BETWEEN MUCUS, EPITHELIUM, AND PUS. 41 

Observations and experiments made known since the publi- 
cation of the first edition of this work compel me to modify 
the view I then expressed, that the formation of pus was not 
due to wandering leucocytes; for Cohnheim, Von Eeckling- 
hausen, Strieker, Sanderson, and others have demonstrated more 
or less clearly that pus corpuscles, at the commencement of every 
acute inflammation, may be derived from the blood — i.e., that 
they may be emigrant white corpuscles which have escaped 
through the walls of the capillaries. But even Cohnheim 
sees that there is nothing in the facts which contradicts the 
previously accepted belief, supported as it is by an over- 
whelming mass of evidence, that the later generations are the 
offspring of the inflamed tissues by proliferation of their cell 
elements. 

The experiments which most strongly demonstrate that the 
white corpuscles have the power of locating themselves in 
inflamed tissues, in virtue of their own inherent power of move-' 
ment, are as follows. Strieker irritated one eye of a frog by 
cauterizing the cornea through, then excised the cornea of the 
opposite eye, and inserted it beneath the membrana nictitans of 
the irritated eye, and finally united the edge of that membrane 
with the opposite margin of the cutis by ligatures. After 
twenty-four hours the transplanted cornea was removed and 
examined, and found to exhibit inflammatory changes, which, 
although on the whole less advanced than those found in an 
unexcised cornea at the same period after irritation, were equally 
characteristic. 

These results scarcely admit of misrepresentation ; they are,, 
however, rendered much more decisive and satisfactory by vary- 
ing the conditions of the experiments in such a way as to show 
that the changes observed are not due to the penetration of 
leucocytes from the liquid in which the cornea is immersed, 
and secondly, that they are not a mere result of its transplanta- 
tion into an unnatural position. The first of these objects is 
readily attained by dividing the cornea immediately after 
excision, plunging one-half in water so as to kill it instantly, 
and then placing the dead and the living portion together 
underneath the membrana nictitans of the opposite eye. It is 
then found that whereas the same inflammatory changes as be- 
fore go on in the living half, the other half remains iuactivej 



42 TERMINATIONS OF INFLAMMATION. 

The second result is attained by the observation of what 
happens when, instead of first cauterizing the eye which is 
destined to be the recipient of the transplanted cornea, it 
is left uninjured. At the end of twenty-four hours the cor- 
puscles of the transplanted cornea are found quite unaltered, 
and so distinct that the plan is strongly recommended as a 
method of demonstrating their normal character. — (Klein, 
Sanderson.) 

These varied results seem therefore to show, beyond the pos- 
sibility of dispute, that the structural changes in the cornea of 
the frog cannot be dependent either upon any influence ex- 
ercised by the nervous system, or by transmission of the irrita- 
tive effects from one structural element to another, so that we 
have good ground for concluding with Professor Strieker that 
they result exclusively from the stimulating influence of the 
exuded liquid. The precise physical or chemical conditions are 
as yet unknown, and are at the present moment subjects of further 
investigation. Whilst these experiments prove that the forma- 
tion of pus is sometimes due to the power of the white corpuscles 
of penetrating living tissue, they do not destroy the facts that 
the formation of pus may be independent of their presence. In 
the case of pus formation in cartilage — where the cartilage cells 
are isolated in cavities in the matrix, having no communication 
with each other, but entirely closed — it is seen when the surface 
of the cartilage is irritated, that the cells in the neighbourhood 
of the irritation enlarge, and expand their capsules. The pro- 
toplasm of which each cell consists becomes more granular, and 
soon contains two corpuscles in its interior instead of one, and 
has a gathering of protoplasmic matter around itself. This 
process of division is repeated in each segment until every 
cavity contains a mass of nucleated cells, which at length as- 
sume characters corresponding with those of newly formed pus 
corpuscles, while at the same time the original interstitial sub- 
stance gradually wastes away and is finally represented by a 
sponge-like stroma, in the holes of which groups of young cells 
are contained. 

In this process we have a typical example of germination ; 
the permanent ceRs which have for their function the main- 
tenance of the unchanging life of the tissue, are replaced by a 
more numerous progeny of transitory mobile cells, which live 



STRANGLES. 43 

at the expense of what remains of the tissue, and eventually 
destroy it. 

TEBTiA PYOGENICA, OR STRANGLES. 

As an example of suppurative disease, associated with a 
varying degree of febrile disturbance, we have in the horse what 
from time immemorial has been termed Strangles. The origin 
of the term strangles arises from the fact that in some cases 
it is associated with symptoms of choking or strangulation, 
and it was divided by the old writers into simple and bastard 
strangles ; the first form being that which ran a regular course, 
and the second consisting in the formation of multiple or suc- 
cessive abscesses. 

Simple strangles may be defined to be a febrile disease, 
generally attacking young horses, and terminating in the 
formation of an abscess or abscesses in the areolar tissue of 
the submaxillary space. 

Irregular or bastard strangles, on the other hand, is a very 
grave affection, in which the connective tissue of the lympha- 
tics of the submaxillary region, and sometimes the salivary 
glands, are the seat of acute suppurative inflammation, asso- 
ciated with a low febrile state of the system, a tendency to 
suppurative action in various parts of the animal body, more 
especially in the mesenteric, bronchial, axillary, and inguinal 
glands, and to purulent infiltrations in the parenchyma of 
organs or into the subcutaneous areolar tissue. 

It is thought by some that strangles is contagious, from the 
circumstance that when one case occurs in a stud others very 
often soon foUow. This, however, is not sufficient proof of its 
being contagious. It is a debateable point whether strangles 
is contagious or not. Many proofs can be brought forward in 
support of either view, some observers stating that they have 
induced it in inoculation— Gohier, Eeynal, Toggia. In some 
instances — like typhoid fever of man — it seems contagious to 
some extent, while in others it shows no tendency to spread 
by this mode. My own experience leads me to conclude that 
it is a non-contagious disease, but whilst there is still any doubt 
about the matter, it is better to take precautions against its 
diffusion by separating the affected from the healthy. 

Although it is generally found to attack young horses, it ia 



44 TERMINATIONS OF INFLAMMATION. 

by no means uncommon to find aged animals take the disease. 
In some localities, and during some years, it assumes the form 
of an enzootic, attacking animals of all ages. 

It is an unsettled question whether horses take_ strangles 
more than once in their lives, and the point is not easily solved, 
as the history of animals is hard to trace. I think it may be 
laid down as a rule that it rarely attacks the same horse more 
than once, after which the predisposition to it disappears. 

The causes of strangles are very obscure. It is thought 
that dentition has something to do with it ; and this may be 
accepted as a tangible reason, as the majority of cases occur 
during the active period of dentition. But it by no means 
follows that this is the only predisposing cause, for animals with 
full mouths are very often attacked with strangles. Domesti- 
cation has also been looked upon as the cause of strangles; but 
this cannot be, otherwise animals that have never been stabled 
would not suffer, whereas horses at grass very often have it. 

Horses from a few months to six years old are the common 
subjects of strangles. When they are very young, the disease . 
generally assumes a virulent form, and often proves fatal, either 
from iaternal abscesses, purulent infiltrations, or a condition 
similar to the hectic fever of human beings. 

Symptoms. — Strangles manifests itself in three ways. 

1st. It commences with the common symptoms of a mUd 
catarrhal affection. The animal is somewhat duU, has a slight 
cough, some soreness of throat, a disinclination to feed, and 
more or less inability to swallow. The submaxillary space 
swells, is hot and tender, the swelling fiUing up the whole 
space or confined to one side only ; and is either diffused or 
circumscribed. There is generally some dribbling of saliva from 
the mouth, and a discharge from the nostrils. In most instances 
the pulse is somewhat hurried, and the respiratory movements 
slightly increased. 

2d. For some weeks, or even months, prior to the local 
manifestation of the disease, the animal is unthrifty, loses flesh, 
becomes hide-bound, drawn up at the flank ; if at grass, stands 
apart from his fellows, has more or less cough, often stretches 
himself as if fatigued, shivers on the application of slight cold, 
his coat stares, his growth is arrested. The horseman says that 
" he is breeding strangles," and time confirms the correctness 



STRANGLES. 45 

of this opinion, the local signs of the disease hecoming developed, 
and very often to a more severe extent than in the first form. 

Sd. The premonitory signs are those which have given the 
name to the disease, namely, those simulating strangulation, with 
great difficulty of respiration, accompanied by a loud trumpet- 
like sound, emitted more especially during inspiration. This 
sound may arise from spasm of the muscles that close the 
glottis, namely, the crico-thyroideus, crico-arytenoideus lateralis, 
thjrro-arytenoideus, &c. ; or from an cedematous condition of it 
(oedema glottidis). If from the first cause, the inspiratory sound 
only is heard; but if from the second, both movements may 
be accompanied by the roaring noise, the inspiratory to a greater 
extent than the expiratory. 

The treatment of regular strangles is very simple, and con- 
sists of fomentations and poultices to the part, to promote the 
growth of the pus ; slight febrifuge medicines, as the nitrate of 
potash, to modify any accompanying fever ; keeping the bowels 
in order by laxative diet or very mild aperients, as oil, or the 
sulphate of magnesia. If the tumour points and bursts spon- 
taneously, it is advisable not to interfere with its course, either 
by incision or external irritants; but if it is indolent, " seeming 
to hang fire," as it were, it is good practice to apply a blister. 
Some writers and teachers condemn this plan of treatment. I 
feel quite sure that such are men of no experience, a blister 
often acting lilce magic in promoting the suppurative action in 
the tumour, or in dispersing it altogether without suppuration. 
The best plan is to apply a good fly blister, and a warm poul- 
tice in about twenty-four hours afterwards. When the abscess 
has burst, aU that is necessary is to keep it clean, and to give 
the animal good food, with tonics, the preparations of iron being 
the best. After apparent recovery from strangles, care must 
be taken not to expose the animal to any debilitating influence, 
as work or cold, too soon, for secondary abscesses may form in 
the internal organs. 

The second form of strangles — ^namely, that ushered in by a 
lengthened period of unthriftiness — ^must be treated locally, in 
the same manner as the first form; but the constitution will 
require to be siipported by good food and tonics before there 
are any local manifestations. If the animal is at grass, it must 
be taken up and protected from the vicissitudes of the weather 



46 TEEMINATIONS OF INFLAMMATION. 

by being lodged in a roomy, airy place ; must have an allow- 
ance of corn — crushed oats in preference; and be regularly 
fed and carefully watched, as the most severe forms of the 
disease, namely, those associated with internal abscesses, are 
ushered in by the above premonitory signs. If the tumours 
suppurate kindly, and the disease runs its course regularly, the 
animal wiU soon regain its former condition, will, in fact, thrive 
better than ever, and will seem as if the system had been rid of 
some deleterious material. 

In the third form, great watchfulness must be used for fear 
that the patient dies of suffocation. To prevent this the opera- 
tion of tracheotomy may have to be performed. 

As to the necessity of this operation, and the time for its 
performance, there is a difference of opinion. Some think it 
ought to be performed early, to enable the glottis to remain in 
a state of repose, and thus recover more speedily than if kept 
in activity by the respiratory movements; while others con- 
demn the operation except as a dernier resort. Of the two 
opinions the former is the more humane and rational, but the 
latter is supported by a more extensive experience. 'Without 
discussing the point, I may state that my own practice con- 
sists in hot fomentations to the throat, succeeded by a mustard 
liniment, making the animal inhale watery vapour for some 
hours and watching the case carefully. If the dyspnoea in- 
crease, I perform tracheotomy ; but if it decrease even slightly, 
I go on with the steaming and fomentations. There is a difli- 
culty in applying poultices to the throat, and I find a good 
substitute in woollen waste confined to the parts within the 
hood. A poultice soon gets cold, and is apt to do more harm 
than good if not carefully applied and continually watched. Hot 
fomentations and packing with wool are therefore preferable. 

In performing tracheotomy, the best plan is to elevate the 
horse's head, extend the nose, so as to draw the inferior cervical 
muscles into a state of tension, then to feel along the course of 
the trachea for the part least covered with muscular and adi- 
pose tissue, and to make a bold incision through the skin 
and subcutaneous structures on to the trachea. The incision 
must be about four inches long, exposing the trachea clearly to 
view. When this is done, introduce the point of a sharp-pointed 
bistoury into tlie trachea, between the upper exposed rings, 



STRANGLES. 47 

divide two or three clearly across, and introduce the tube, taking 
care in doing so that the divided rings are not pressed into the 
trachea. 

The tracheotomy tube must be tied around the animal's neck 
and to the mane, in order to keep it steadily in position. 

There is no need for casting the horse for this operation ; if 
it be quickly done, there is scarcely a necessity for the twitch, 
as the poor animal is too ill to be very unruly. The tube 
should be kept in until it is manifest that the animal is able 
to breathe freely through the nostrils. This is ascertained by 
putting the hand over the tube for a few minutes, when, if the 
patient breathes naturally and without distress, it may be re- 
moved, and the lips of the wound brought together by metallic 
sutures. 

In a period varying from a day to a week after the first symp- 
toms, the local manifestations of strangles are developed, and 
until these are apparent, the disease is classified as laryngitis. 

The local lesions are generally much more severe than in 
the first or even second form. The tumours are multiple, or 
diffused over the sides of the face, nostrils, submaxillary space, 
and parotidean region ; suppurating at several points, and dis- 
charging an unhealthy pus. Horses confined in Ul- ventilated 
stables suffer most commonly from this form, and if not removed 
to a healthier situation, it is apt to degenerate into a hectic con- 
dition, succeeded by pyaemia, or to terminate in glanders. 

The hectic condition is that in which the animal continues 
to lose flesh very rapidly, to have a discharge from one or 
both nostrils of a tenacious muco-purulent material. Abscesses 
continue to be formed one after another on the face and the 
submaxillary space ; the patient becomes hide-bound, with a dry, 
scurfy skin, and drawn up in the flank. The hair of the mane 
and the tail is easily pulled out ; the pulse is soft, compressible, 
feeble, and quick ; the legs, at first fine, begin to swell, and the 
various serous cavities fill with serum, the patient becoming 
affected with glanders and farcy, or it may die of exhaustion, 
diarrhoea, excessive secretion of urine, loaded with hippurates 
and oxalates, or of dropsy of the serous cavities. 

The treatment of this condition consists first in the removal 
of the horse from an unhealthy to a healthy situation. He 
should be kept in a box by himself, and have, in addition to 



48 TERMINATIONS OF INFLAMMATION. 

a liberal allowance of corn, hay, or grass, a gallon of new milk 
during the day ; he wiU soon become fond of it. He should 
be made to drink it instead of water, and if kept without the 
latter for a few hours, will drink the milk with avidity. If the 
appetite is entirely lost, six eggs ought to be beaten up and 
mixed with each gallon of milk. 

The strength must also be kept up with tonics, iron, quinine, 
wine, or beer, and acids ; and should these fail, nux vomica and 
arsenic in small doses. 

I have seen many cases of this kind of mal-condition, which 
I have ventured to compare to the hectic fever of the human 
being, rapidly recover, with very little treatment, after being 
removed from a crowded stable to an airy, loose box. 

PviEMiA differs from the latter condition by the development 
of abscesses, or of purulent infiltrations in various internal 
organs, and from irregular strangles by the abscesses being 
secondary to, and not concomitant with, those in the sub- 
maxillary space. In reality there is but little difference, 
except that in the one case the internal collections of pus 
are due to a diathesis, and in the other to the absorption of 
some deleterious material generated in the pus of the primary 
abscess. 

Mr. Haycock was, I think, the first to point out the occur- 
rence of pyEemia succeeding strangles (see liis Contribution to 
Veterinary Patlwlogy, 1849-50), under the term " Phlebitis." 
Since then the subject has received considerable attention, but 
even to this day cases are described as pysemia which are in 
reality extensive abscesses, infiltrations, excessive suppurations, 
or farcy. 

Pyaemia may be defined to be a typhoid condition, accom- 
panied by miiltiple abscesses or purulent infiltrations into one 
or more organs, resulting generally from strangles, parturition, 
and from injury or surgical operation. 

Four theories have been promulgated with the view of ex- 
plaining the pathognomy of pyaemia: — 

1st. " That this condition is owing to an admixtxire of the 
blood with pus (pyohemia of Piorry), and that the pus corpuscles 
being larger than the coloured ones of blood, are arrested in 
the minute capillaries, and give rise to secondary abscesses. 
2d. That it is owing to the presence of some irritant body, 



PYEMIA. 49 

which, not being able to escape from the economy, produces 
capillary phlebitis, od. That it is dependent on a property 
possessed by pus of coagulating the blood. Mi. That it is 
caused by the presence of a peculiar poison, which contaminates 
the system." — (Bennett.) 

The first theory is founded upon the assumption that pus cells 
differ from the white globules of the blood ; whereas in reality no 
actual difference, either in size, structure, or behaviour, on the 
addition of re-agents can be detected ; therefore, if the capillaries 
are sufficiently large to admit the passage of the white blood 
glob^^le, they must consecLuently be large enough to admit the 
passage of the pus cell. 

The second explanation was advanced by Cruveilhier, who, 
on injecting mercury, ink, and other substances into the blood 
of a living animal, found that abscesses were formed wherever 
these accumulated ; hence it seemed to follow that the impaction 
of certain substances in the tissues may induce local inflamma- 
tions, and lead to abscesses ; but that such is not the necessary 
result of admixture of pus with the blood is proved not only 
by the previous observations, but by numerous experiments of 
Lebert and S(^dLLlot, in which the animals recovered. 

The third doctrine was advanced by Mr. Henry Lee, and 
resulted from observing that when pus was mingled with 
recently drawn blood, it coagulated more rapidly and more 
firmly than under ordinary circumstances. 

But although this may be true as regards pus when mixed 
with recently drawn blood, it does not follow that it induces 
coagulation of living blood in the vessels of an animal ; and 
numerous experiments by Lebert, Sddillot, Bennett, and the 
late Professor Barlow, show that such does not take place : in 
some cases death followed, in others the animals lived, and the 
pus corpuscles were dissolved. 

The fourth theory is based upon the opinion that good pus is 
innocuous, and that the bad effects occasionally produced depend 
on its becoming putrid, or being otherwise altered. It is now 
generally believed that pyaemia is due to a poisonous principle 
associated with the pus ; hence it is proposed to substitute the 
terms ichorsemia (ViRCHOW), or septicaemia (Vogel), for pyemia. 

The signs of pyaemia may not manifest themselves for some 
time after the primary abscess has discharged itself; never in 

£ 



50 TERMINATIONS OF INFLAMMATION. 

my experience before the pus lias come into contact with the 
atmosphere, and they will depend upon the seat of the second- 
ary piu'ulent collections. In the human patient the symptoms 
are very characteristic ; in addition to others, the breath has a 
smell of new-made hay, and the skin, especially by the side of 
the nose, and about the eyebrows, becomes yellow ; but in the 
horse tliese are not recognisable. In one case of purulent 
infiltration into the lungs succeeding strangles, I did think 
that the smell of new hay was present; but it was soon 
succeeded by a most offensive odour of decomposing animal 
matter. I think the most prominent and characteristic sign 
is a total loss of appetite, or an apparent loathing of food, 
associated with occasional colicky pains when the abscesses are 
in the mesentery; with symptoms of pneumonia and foetid 
breath when in the lungs, and yellowness of the mucous mem- 
branes when in the Hver. The animal's head is held low and 
drooping, the countenance is sunken and cadaverous looking, 
and the body generally emaciated. 

Haycock describes it as phlebitis, and it appears that in his 
case inflammation of the veins was present ; but it by no means 
follows that this is always the case. I have made careful ex- 
aminations of several, and found this condition sometimes pre- 
sent, sometimes absent. 

As regards treatment, I know of none that can arrest the 
progress of the disease when it has set in ; all that can be done 
is to be careful that the surroundings of a case of strangles are 
healtliy, specially avoiding bad drainage and bad ventilation. 
When I was in practice at Bradford, in Yorkshire, nearly every 
case of strangles which occurred near the Bradford Beck (brook 
or rivulet) and Canal proved fatal, pysemia supervening; this 
■fatal result could only be accounted for by the putridity of the 
water, both in the canal and the beck, and by the exhalations 
from them having found their way into the stables in their 
neighbourhood, and set up a septic fermentation in the pus 
when exposed to their contaminating influence. 

If the secondary abscesses form near the surface of the body, 
as in the groin or subscapular region, they must be opened, 
and in all cases the animal must be supported with tonics, 
good food, milk, eggs, wine, beer, quinine, and small doses of 
-the chlorate of potash; but should the lymphatics become 



PYEMIA. 51 



corded, and abscesses form in the glands along their course, 
the disease will have degenerated into farcy, and may ulti- 
mately terminate in glanders. 



EE-ABSORPTION OF PUS. 

It was imagined at one time that pus might again be taken 
up from the different points at which it had been formed, and 
that a favourable turn was thereby effected in a suppurative 
disease; but pus, as pus, is not absorbed; and it is always 
its fluid part (liquor puris) which is taken up, and as this dis- 
appears the pus becomes thicker, constituting what is termed 
inspissated pus, which contains the pus cells in a shrivelled 
condition. Not only is the serum in which the cells float ab- 
sorbed, but also that contained within them ; and in proportion 
as this is the case, the cells become smaller, more irregular, 
more angular, more uneven ; they assume the most singular 
forms, Lie closely pressed together, forming the cheesy concre- 
tions which have been confounded with tubercle. 

There is another method by which pus is removed, — that is, 
by fatty degeneration of the pus cells. Every cell sets fatty 
particles free within it — breaks up ; and at last nothing remains 
but fat granules and intervening fluid of a milky appearance, 
and constituting what is termed 'pathological milk, which is 
absorbed: here, again, pus is not re-absorbed as pus, but as 
water, fat, and salts. — (Virchow.) 

Inspissated pus, in pieces of varying size, dry and hard, is 
often found in the guttural pouches of subjects on the dissecting 
table ; these are the results of preceding catarrhal attacks and 
formation of pus in these cavities. They are also found in old 
abscesses, and give rise to tumours in various parts of the body. 
— {S&& TUMOUES.) 

FOEMATION OF SINUSES. 

When pus is seated in parts, the action of which is defective 
owing to local or general causes, or when it cannot be completely 
evacuated, the cavity that remains does not contract completely, 
and the wound is called a sinus or fistula. 

In the course of time the surface of the sinus becomes smooth 
and condensed, so as to resemble mucous membrane, or even 



52 TEEmNATIONS OF INFLAMMATION. 

skin, being, in old confirmed cases, lined with a downy hair, and 
so thick and callous that its waUs resemble cartilage in their 
hardness. This hardening of the walls was formerly thought to 
depend upon a morbid disposition of the part, and to require 
extirpation, as an essential step to the animal's recovery. The 
applications and operations practised for this purpose were ex- 
tremely severe, consisting of the actual cautery, arsenic, corrosive 
sublimate, and other powerful escharotics; but a more enlightened 
pathology has led to their disuse, and it is now found sufficient 
simply to remove the cause of the irritation. 

" In treating sinuses, the objects are to promote gTanulatuig 
action on their surfaces, and to press their sides together. They 
are not healed \>j filling up, anymore than the original cavity of 
the abscess, but contract until they become obliterated, or close 
more directly by union of the opposite surfaces." — (Syme.) 

Great care must be taken to avoid confining the discharge 
of the sinus, since, if prevented from escaping, it distends the 
sides of the cavity, and for the same reason it is always proper 
to afford the matter an opening for its complete escape, either 
by enlarging the one already existing, or making a new one. 
The method of doing this will be explained hereafter in connec- 
tion with the different regions in which sinuses are apt to be 
seated. 

ULCERATION. 

Ulceration is another result of inflammation : it consists 
essentially in molecular degeneration of a part, and goes on by 
three simultaneous processes. (1.) An exudation of inflamma- 
tory lymph and serum surrounds the mass of young cells, which 
constantly continue to grow on the surface, and at the margin 
of the ulcer, causing the destruction of the normal textures. 
(2.) Cells are thus continually growing on the surface, to be 
carried off by fresh exudation. (3.) Lic[uefaction of the 
gelatinous interstitial material supervenes, and so destruction 
of tissue takes place continually. — (Goodsie, Aitken.) 

The difference between ulceration and mortification will be 
described hereafter, but I may here state that I cannot conceive 
ulceration to be molecular death of a part, but rather the absorp- 
tion of living degenerate textures, by which gaps or solutions of 
continuity are formed. 



ULCERATION. 53 



VAEIETIES AND TREATMENT OF ULCERS. 

An ulcer is defined to be a solution of continuity caused by 
idceration, and its varieties in A^eterinary Surgery may be 
arranged under six heads. 1st. Healthy ulcer ; 2d. Weak ulcer ; 
3d. Indolent ulcer; 4:th. Inflamed ulcer; 5th. Gangrenous or 
phagedenic, or sloughing ulcer ; and &th. Specific ulcer. 

Is^. The healthy ulcer is smooth at its edges, which are 
neither everted nor inverted, adherent to the granulations, and 
when they rise to a level with the skin, a film or cicatrix is 
formed like a semi-transparent ring round the edges, and 
gradually spreads over the wound. The granulations are small, 
firm, numerous, and of a fine florid colour, pointed at their tops, 
and discharging a thick laudable pus. 

But little treatment is required for this kind of ulcer, beyond 
rest and cleanliness. 

2d. The weak ulcer. The granulations are pale, large, flabby, 
not pointed, but even bulbous at their tops, less vascular, and 
less apt to bleed on being touched than those of the healthy 
ulcer; they are unattended with pain, rise above the level of 
the skin, so that the margins of the ulcer are hid from view. 
The discharge is thin, pale, and watery. 

This kind of ulcer is caused by some debilitating local or 
general influence. It is often found in the hind legs of low- 
bred animals, and arises in them from the venous congestion 
and dropsical effusion, which are so often met with in round- 
legged cart horses. It is associated perhaps with some con- 
stitutional weakness, arising from bad food, or other cause of 
general debility. Healthy ulcers, when improperly treated, are 
apt to degenerate to this form. 

The treatment ought to consist of some mild astringent 
dressing, as the solution of sulphate of zinc or of copper, the 
periodical use of the nitrate of silver— say, every three days, if 
thought requisite — and the careful application of a bandage, 
both to the ulcer and to its neighbourhood, in order to stimulate 
the granulations and to correct the tendency to congestion. 
The general system, is to be corrected by a gentle purgative, 
succeeded by tonics and diuretics; at the same time the 
strength is to be kept up by good, nourishing, but easily 
digestible food, dry food being preferable to moist. The patient 



54 TEEMINATIONS OF INFLAMMATION. 

ought to have regular exercise, and great attention must be paid 
to cleanliness. 

M. Indolent ulcer, found usually about the coronet of old 
horses. Its edges are thick, prominent, comparatively insensible, 
smooth, shining, firm, incompressible, and without any appear- 
ance of cicatrix ; the surrounding parts are swollen, hard, in- 
compressible, and if the skin be white, discoloration wiU be 
seen from congestion of the vessels; the surface of the ulcer 
is nearly devoid of granulations, smooth, glossy, and whitish, 
grey, or brown in colour; the discharge is thin, watery, and 
scanty. The treatment of this ulcer is by blister, succeeded by 
gently stimulating dressings, but bandages do more harm than 
good. The constitutional treatment must depend upon the 
condition of the animal, but generally a purgative is useful. 

4ili. Inflamed ulcer. The edges are red or purple, swollen, 
hot, tense, tender, and painful; the sore presents no granula- 
tions, but has a raw, pulpy, foul, and even livid appearance; 
the discharge is offensive, profuse, mingled with blood and 
ulcerative dihris; the pain is great, and there is always some 
attendant fever. This ulcer may be caused by the presence of 
some foreign body in the part, which must be removed ; it may 
be a piece of dead tissue, skin, ligament, or bone, as when this 
ulcer is produced by a tread. "Whatever it be, the first step in 
the treatment must be its removal. This being done, the in- 
flamed ulcer must be converted into a healthy one by means 
calculated to subdue excessive irritability. The most useful 
local applications for this purpose are warm fomentations and 
poultices, combined with opiates ; the general treatment to con- 
sist of a purgative, succeeded by febrifuges, and the diet to be 
light, and easy of digestion. 

5th. The phag jdenic, gangrenous, or sloughing ulcer, which 
may arise from constitutional debility or from local causes, as 
frost-bites, is that in which the edges are very irregidar, and of 
a dark purple appearance, extending a considerable way into the 
surrounding parts ; they are often inverted, and exceedingly 
painful. The surface of the ulcer is uneven, of a dark, livid 
colour, presenting a very irritable appearance and much sur- 
rounding swelling. The discharge is thin, ichorous, and mixed 
with blood. The ulcer enlarges with great rapidity, the de- 
structive process being carried on both by ulceration and 



VARIETIES AND TKEATMENT OF ULCERS. 55 

sloughing. In some cases many points of ulceration form in 
the neighbourhood of each other, the ulceration taking place 
around several central sloughs ; these by enlargement coalesce, 
and ultimately form one large ulcer, embracing, as in some 
cases of " carbuncle of the coronary band," a space of several 
inches. The treatment of this variety is a matter of great 
urgency and importance, but not always satisfactory. 

Treatment. — Free scarifications of the part, to relieve con- 
gestion ; the removal of all sources of irritation, and the appli- 
cation of emollient and antiseptic poultices or fomentations, 
constitute the best local treatment. If the ulceration continues 
to spread, I have seen benefit arise from the gentle application 
of nitrate of silver to the edges. The constitutional derange- 
ment must be treated by purgatives, anodynes, or sedatives, 
succeeded by tonics ; and the diet regulated according to the 
stage and variety of the accompanying symptoms. 

Specific ulcers will be described with the diseases of which 
they are symjjtomatic. 



MORTIFICATION, OR DEATH OF A PART. 

This is of two kinds, complete and incomplete. In the soft 
structures, the first is called sphacelus, and the second gangrene ; 
whilst mortification of the blood is termed necrfemia, and that 
of the hard structures, as the bones, necrosis. When the dead 
tissue is visible to the naked eye, it is called a slough ; when it 
is soft, the process is called sloughing, which means the pro- 
gressive death of the part as well as the process by which the 
slough is separated; the same meaning is applied to exfoliation, 
or the process of separating a sequestrum or dead piece of bone. 
But so long as the dead particles of tissue ejected in the 
ulcerative process are in the form of minute particles, visible 
only with the microscope, the disease is spoken of as ulceration, 
not mortification or sloughing. 

Degeneration of a part may be distinguished from its death 
by the fact that the degenerated part never putrifies, and that 
no process (sloughing) ensues for its separation or isolation, such 
as can be seen in the case of a dead part. " However degenerate 
a tissue may be, it either remains in continuity with those 
around it, or it is absorbed. If the same tissue were dead. 



56 TERMINATIONS OF INFLAMMATION. 

those around it would separate from it, and it would be ejected 
from them."— (Paget.) 

Mortification of the soft parts may be white or black in 
appearance, and it may be humid (moist) or dry. The mortified 
part has a black appearance when the blood is extravasated 
into the tissue, giving it a purple or dingy hue, whilst to the 
touch it is soft and doughy. It has a dull-white appearance in 
i'rost-bites, when by the action of cold the blood has been 
driven from the part. 

Moist gangrene occurs when the blood transudes, and after 
its transudation separates into its constituent parts. The serum 
being set free, dissolves the red globules, raises up the surface 
of the cuticle in bladders, forming what are termed " phlyctense." 
Air generated by incipient putrefaction is not unfrequently 
contained in the phlyctenjE, giving to the finger touching the 
part a sensation of crepitation. 

Dry mortification is very rarely met with, but it has been 
observed to follow the use of ergotised rye as food on the Con- 
tinent of Europe, where it not only attacks the lower animals, 
but human beings, in the form of mortification of the extremities. 
It may, however, occur in any part of the body which has been 
deprived of its blood and a further supply cut off. Sloughing 
of the cornea has been observed in animals fed upon food defi- 
cient in nitrogenous elements, and in my experience cases 
have occurred of sloughing of the tail from dry gangrene in 
horned cattle that have been starved, ill-treated, or have suffered 
from debilitating diseases or old age. This form of mortification 
may also be observed in the course of scarlatina in the horse, 
" when some extreme part of the organism, such as the ears, 
will suddenly present a blanched appearance; the skin of these 
organs will suddenly shrink and become hard and dry, as 
though frozen, and in the course of a day or two these blanched 
portions snap of, leaving exposed a raw surface, which speedily 
suppurates." — (Haycock.) Mortification of the tails of mon- 
keys is too well known to need comment. 

NECEiEMlA, or death of the blood, is well shown in those dire 
diseases which affect horned cattle, namely, splenic apoplexy 
and quarter-ill. In these diseases we have local manifestations 
of the general blood crasis, by the development of large patches 
of extravasation of dead and decomposing blood, the death and 



MOETIFICATION. 57 

decomposition being apparent in the part by the formation or 
escape of the gaseous products of putrefaction simultaneously 
with the appearance of the extravasation, giving the swellings 
a feeling of crepitation even at the very outset of the disease. 

Mortification may arise independently of the inflammatory 
process from defective quantity of blood in a part. This 
may be due to obstruction of its artery of supply, owing to 
injury, the formation of a clot within, or pressure constantly 
maintained upon it. Portions of tissue may also perish when, 
by ^ injury or by progressive ulceration or absorption, all 
their minute blood-vessels are destroyed and their supply of 
blood cut off. I have seen a case where aU the gluteal muscles 
of one side were mortified, from the small arteries having 
been crushed and destroyed in a railway accident, but where 
the larger arteries of supply did not suffer. The horse lived 
several days. 

Necrosis may follow the separation of periosteum from the 
surface of a bone, when it is either stripped off or raised by 
effusion, or when there is suppuration beneath it. 

Sometimes a tumour will slough in its centre from defective 
supply of blood. Again, a part wiU slough from the application 
of a strong chemical agent, as corrosive sublimate or arsenious 
acid. 

Blood defective in quality also produces mortification, without 
being accompanied by inflammation, and occasionally mere 
passive congestion of a part may lead to its death ; but this- is 
a rare occurrence. 

The simplest example of mortification of a part, not from 
deficiency of blood in it, is that from strangulation, as in 
strangulated hernia. Here, if the strangulation is sudden and 
complete, the stagnation is equally so, and the death of the 
part follows very quickly, with but little excess of blood in it. 
But if the strangulation be less in degree, the veins suffer more 
from the gradual compression than the arteries do ; the vessels 
become engorged with blood admitted to them faster than it can 
leave them, and so, after intense congestion, mortification ensues. 
(Example — inversion of the uterus.) 

The mortification arising from passive congestion and that 
from strangulation are said to arise from defect in the flow 
of the blood. 



58 TEEMINATIONS OF INFLAMMATION. 

The other form of mortification we have to deal with is that 
which goes under the denomination of Inflammatory Mortifica- 
tion. The death of an inflamed part is a very complex matter, 
and in certain kinds of it stagnation, degeneration, and pres- 
sure may act as causes. Thus, inflammatory congestion may 
end in perfect stagnation of the blood in the vessels, the blood 
so stagnated may mortify or die, and this death of the blood 
may lead to the mortification of the tissues that need it for 
their support. 

Degeneration of the proper tissues of the part is a constant 
accompaniment of the inflammatory process, and this degenera- 
tion may result in death, from absence of the proper conditions 
of nutrition; and, again, effusion of fluid may so compress the 
inflamed part, and, by the swelling, so elongate the blood-vessels, 
as to diminish the influx of fresh blood, even when little of that 
which is in the part is stagnant. 

The intensity of an inflammation is not alone a measure of 
the probability of mortification ensuing, neither is mere debility, 
for we see inflammations without mortification in very enfeebled 
cases. Want of condition in an animal, if put to severe exertion, 
will often cause mortification from excessive congestion, espe- 
cially of the lungs, the mortification here seeming to arise from 
complete stagnation of the blood in the pulmonary vessels, with 
death of that blood. Again, in enteritis, mortification ensues 
from severity of the congestive rather than the truly inflamma- 
tory process. Cases of partial gangrene of the lungs, depending 
on pneumonia affecting bad-constitutioned animals, more espe- 
cially if such have been kept in ill-drained or ill-ventilated 
stables, are not uncommon. 

When a mortification has a disposition to spread, its dark 
colour is gradually lost in the surrounding parts, whereas, when 
it ceases to spread, a red line, called the hne of demarcation, 
separates the dead from the living parts. This line is always 
regarded as most important, indicating that sloughing has ceased 
to spread, and that a process has begun for the removal of the 
sphacelated part from the system. 

In this process, consolidation of the tissues by the formation 
of organizable lymph precedes the suppuration and ulceration ; 
and thus haemorrhage from the vessels and infiltration of the 
decomposing material into loose structures are both prevented. 



MOKTinCATION. 59 

The final act in the separation of dead tissue is that of 
ulceration of portions of living tissue, which are in immediate 
contact with the dead. A groove is formed by this ulceration, 
which circumscribes and entrenches the dead part, and then, 
gradually deepening and converging, undermines it, till, reach- 
ing its centre, the separation is complete, and the slough falls 
oft', or is dislodged by the discharge of the ulcerated living 
surface. Concomitant with this process of destruction, one of 
repair is set up ; as the ulcerated groove deepens, so do granu- 
lation cells rise from its surface, so that, as one might say, that 
which was yesterday ulcerating is to-day granulating ; and thus, 
very soon after the slough has separated, the whole surface of 
the living part, from which it was detached, is covered with 
granulations, and proceeds lilce an ordinary ulcer towards healing. 
There is one peculiarity in mortification, namely, mortification 
lyy contact. Thus a spot of mortification of the size of a five- 
shilling piece is discovered upon a portion of intestine, sur- 
rounded by perfectly healthy structures, until the portion of 
the intestine in immediate contact with the gangrenous spot 
is examined. This will be found to be gangrenous also, 
although, when divested of its convolutions, it may be several 
feet from the originally mortified spot, the intervening length 
of grit being free from mortification. 



CHAPTER III. 

SYMPTOMS OF INFLAMMATION. 

CENERAIi SYMPTOMS OF INFLAMMATION INFLAMMATORY APPEAB- 

ANCES OF THE BLOOD TREATMENT OF INFLAMMATION TREAT- 
MENT OF CHRONIC INFLAMMATION. 

The symptoms of inflammation are of two kinds, namely, local 
and constitutional. The first-named have been already de- 
scribed. The constitutional symptoms are those indicative of 
sympathetic, symptomatic, or inflammatory fever, and are of the 
greatest importance, indicating the nature of the disease when 
the inflammation exists in an internal organ removed from sight 
or touch, and often guiding the method of treatment. There 
are some inflammations that are unattended by any appreciable 
signs of fever; others, again, by symptoms that are so in- 
significant as to pass unobserved; but when an inflammation 
is sufficiently extensive, the general system is disturbed by fever 
(pyrexia). 

Prominent amongst the symptoms of inflammatory fever 
are rigors (shiverings), elevation of internal temperature, and 
debility ; followed by, or alternating with, increased heat of 
skin, increased frequency, perhaps force, and often hardness of 
the pulse, with disturbance or derangement of the natural 
functions of the animal body. The rigors are sometimes severe, 
or amounting only to mere chilliness, a slight staring of the coat 
being the only sign; but they are always important, as they 
mark the outset of the febrile disturbance, and it is worth 
observing that rigors more commonly attend the commencement 
of spontaneous inflammation than of inflammation caused by 
external injuries. They are of very frequent occurrence in 
horses that present no signs of local disease ; they are dull, off 



GENERAL SYMPTOMS. 61 

their feed, seemingly little wrong or amiss, but the coat is 
harsh and staring, and actual shivering is easily induced. An 
animal in such a state may be on the eve of an attack of 
severe inflammation of some important internal organ. Gene- 
rally speaking, the febrile state succeeds the manifestations of 
the local symptoms of the inflammation, and therefore it may 
be considered generally that the fever is the natural effect of 
the inflammation. 

The inflammatory fever is not always proportioned in its 
degree of violence to either the size or the importance of the 
part inflamed. It may be modified in the outset, or very early 
indeed, by the nature of the part upon which the inflammation 
has seized. In inflammation of the stomach and bowels, and 
some of the other abdominal organs, and particularly in traumatic 
peritonitis, the disease has a peculiarly depressive efi"ect upon 
the action of the lieart, and this gives a peculiar character to 
the fever, lessens the amount of the reaction, or abridges its 
duration — affects especially the character of the pulse, which is 
here small and thready, and carries with it a strong tendency 
to death, by failure of the heart's action (asthenia). 

The smaU and thready pulse, being chiefly observed in inflam- 
mation of the abdominal organs, has been called the abdominal 
pidse, the artery resembling a hard thrilling thread. 

As observed in connection with surgical practice, inflammatory 
fever is always a secondary affection. A most minute description 
of it is given by Professor Miller, which I shall endeavour to 
condense, and apply to what is observable in Veterinary Surgery; 
and, like Professor Miller, I shall consider the disorder of the 
general frame according to its systems. 

1st. The Nervous. — There are, if one might judge, dull pains 
in various parts of the animal body, stiffness in the loins and 
in the limbs, restlessness, and a variety of postures, especially 
of the limbs, shifting from one leg to another, pointing of the 
feet ; and when the respiratory organs are not the seat of the 
inflammation, frequent lying down for a short time ; no desire for 
natural movement, dulness, walking performed sluggishly, and 
with manifest disincHnation ; watchfulness, the senses of sight 
and hearing being evidently exalted ; and in aggravated cases 
as those arising from neglected wounds in the feet, delirium 
and coma may ensue, the eyes red and suffused, the visible 



62 SYMPTOMS OF INFLAMMATION. 

mucous membrane red and injected, and the skin hot and dry, 
or partial sweats bedew the body. 

M. The Vascular. — The pulse indicates excitement; it is 
increased in frequency, ranging from 60 to 90, or even to 120 
per minute, hard, rolling like a cord below the finger, and 
yielding but little to its pressure. The arterial coats are 
exercising an increased amount of tonicity, and resist the im- 
pulse of the blood; or an irregularity of movement in the 
artery may exist, and thus a thrill or jar is imparted to the 
finger. There is increased fulness, as if the vessel itself were 
enlarged and held a larger quantity of blood at each impulse ; 
the heart is acting, not only more rapidly, but more powerfully, 
than in health, and the circulation is truly accelerated; fre- 
quency, hardness, or thrilling is seldom absent, but fulness may 
be wanting, and the pulse may be small instead of full. This 
is observable, as already mentioned, in serious abdominal dis- 
ease. The small thready pulse always exists in connection 
with great nervous depression, and debilitated through rapid 
action of the heart, to which circumstance its smallness is pro- 
bably due. In affections of the brain, and in non-inflammatory 
disorders of the stomach producing coma, the pulse is commonly 
slow and full, the suspension of cerebral influence appearing 
to diminish the rapidity, without affecting the force of the 
heart's action. There are peculiarities also to be taken into 
account. The pulse may be naturally slow, intermittent, or 
rapid ; in the common-bred cart-horse, perhaps not above 30 or 
35 ; in the thorough or highly-bred horse, especially if he be of 
a nervous temperament, 45 or 60 ; and in some animals of both 
descriptions intermitting, from some unknown cause or peculiar 
idiosyncrasy. Allowance must be made for these when previous 
inquiry has satisfied us that our patient is the subject of one or 
other of these peculiarities. 

M. The Respiratory. — Eespiration is quickened, the breath 
is hotter than usual — in stable phraseology, the horse Mows. 

Ath. TJie Digestive. — The appearance of the tongue does not 
vary in our patients as much as in the human being, but the 
mouth is dry, hot, and injected, soapy, lathery, and sometimes 
the tongue is contracted, and the secretions of the mouth sour 
or even foetid. There is sometimes very great thirst, loss of 
appetite and loathing of food, and the bowels are constipated. 



GENEKAL SYMPTOMS. 63 

Uh. Tlw Secerning. — The secretions and excretions in general 
are materially diminislied ; the bowels are constipated, mainly 
from want of mucous secretion from their lining membrane ; the 
skin is hot and dry ; or, if pain be the characteristic of the local 
inllammation, there will be partial sweats on the surface of the 
body ; the mouth is parched and dry ; the urine is scanty, high- 
coloured, sparingly aqueous, and holding much saline matter in 
solution. 

%th. The Nutritive. — ^Digestion and assimilation are interrupted; 
as the fever advances, so does emaciation ; and strength becomes 
more and more reduced. 

As already observed, there is no fixed relation between the 
degree or intensity of internal inflammations and the constitu- 
tional fever attending them ; nor is the fever always propor- 
tioned in its degree of violence to either the size or importance 
of the part inflamed. This is insisted on by Drs. Alison and 
AVatson, and their conclusions may be accepted, and shortly 
stated. Dr. Alison writes : — " In some cases where we are 
sure that we have had inflammation going on under our inspec- 
tion to extensive effusion of pus, the pulse has been feeble, the 
skin cool and damp, and the patient exhausted and faint on 
the slightest exertion ; while in others there is high and more 
inflammatory fever, and in some of these the organ inflamed 
has been so to no extent, and its function comparatively little 
affected, but yet the patient has become comatose early, as in 
typhus, and died so." Every veterinarian of experience wiU be 
able to bear out the correctness of these observations from the 
statistics of his own practice. Many inflammations wiU have 
come under his notice where the danger has been compara- 
tively slight, and the fever high; and others where the local 
inflammation has been most imminent, and the accompany- 
ing fever has been hardly observable. The situation, the 
extent, and the degi'ee of the local inflammation being the same, 
the fever generally runs higher in the young plethoric animal 
than in the more aged class of patients. Young horses newly 
bought from the breeder, and brought into large towns, suffer 
more severely from fever, when the local disease is perhaps 
very trivial, than those which are used to town work, town diet, 
and management, and are in what is termed condition.^ The 
T^ype of the inflammatory fever is modified by other circura- 



64 SYMPTOMS OF INFLAMMATION. 

stances, such as the state of the atmosphere, ventihition, drain- 
age, and when any zymotic disease is associated with the 
local inflammation. Animals which are located in coimtry 
districts present a much higher type of fever, and bear blood- 
letting much better than those crowded together in large town 
establishments. Again, the fever is modified in its expression 
by the nature of the part that is inflamed. The pulse and fever 
that accompany acute laminitis are at once characteristic of the 
disease, and no man of common observing powers would fail to 
recognise this formidable malady if he once felt the pulse, strong, 
hard, and full, and continuing so for days even after the vital 
powers have begun to fail. The type of the fever undergoes 
a change when suppuration takes place ; when it (the fever) con- 
tinues long, and when mortification or gangrene occurs to any 
extent. The febrile state generally follows the local disease, but 
there is good reason to believe that the pyrexial condition and 
the condition of inflammation in a part may be excited, in some 
instances, conjointly; or, at all events, their periods of com- 
mencement may correspond so closely that it is difficult to 
conceive that one is the effect of the other. There is every 
reason to believe that, in some instances, the fever precedes 
the local inflammation ; as in strangles, where it may be said 
to be present in some cases for an , indefinite but short period 
l)efore there is any manifestation of local symptoms. The animal 
is then said to be " breeding strangles" and in epizootic pneu- 
monia in the horse, I am convinced that, in many instances, 
the local inflammation succeeds the fever, and that much of the 
non-success in the treatment of this disease has arisen from 
ignorance of this fact. 

When inflammation proceeds to suppuration a severe fit of 
shivering is often the first indication of the formation of pus. 
The nature of the fever then alters, and becomes characterised 
(except in laminitis, and acute suppurative arthritis, or an open 
joint) by softness and feebleness of the pulse, and by much ner- 
vous prostration and debility. A copious formation of pus may 
proceed from a mucous membrane without any appreciable 
degree of suffering, whilst a most trifling amouat of pus from a 
serous or synovial membrane will be often associated with fever 
of even a fatal character. In any case, the character of the 
fever depends greatly on the constitution of the patient : if this 



aF.NERAL SYMPTOMS. 65 

be good, the fever is characterised by much heat, and a strong, 
fuU pulse; on the contrary, if the animal's constitution be 
impaired, or if it be out of condition, the fever is of a low 
type, called typhoid, asthenic, or adynamic, and is charac- 
terised by prostration, sinking of the pulse, great impairment 
of the heart's action, with a tendency to collapse ; and the skin 
is covered by cold, clammy sweats. Sometimes these adynamic 
characters pass into that typhoid state in which nervous symp- 
toms, such as delirium, coma, and tremors, prevail. These 
characters are known as nervous or ataxic. There is uncon- 
sciousness, grinding of the teeth, the mouth becomes foetid, the 
tongue dry, and tremors affect the voluntary muscles. This 
form sets in as a result of some unhealthy tendency of the 
inflammatory process, or when mortification of the inflamed 
part occurs ; but any cause by which the system becomes 
vitiated wiU bring about this kind of fever without death 
of the inflamed part, such as the poison of rinderpest, acute 
glanders, and other allied diseases. Putrescence of the pro- 
ducts of inflammation, degenerating and decomposing, poison 
the fluids circulating amongst them, and when absorbed induce 
the typhoid state. This form of fever tends to death by com- 
plete sinking of the circulation, with diminution and loss of 
animal heat ; or deepening stupor, with oppressed respiration, 
supervenes ; or the animal dies by combination of both asthenia 
and coma. 

Be it understood, however, that sympathetic inflammatory 
fever is especially marked by the absence of certain symptoms 
which distinguish the idiopathic fever, more especially of 
petechise, and of any special eruption on the skin. 

INFLAMMATORY APPEAEANCES OE THE BLOOD. 

The chief appreciable change in the constitution of the blood 
is a great increase in the quantity of its fibrine, which, accord- 
ing to Andral and others, may range from 2^ to 10 per 1000 
parts. It is, however, a very difficult matter to ascertain with 
any certainty the exact increase, for it is impossible, by any 
process yet discovered, to separate the fibrine from the white 
corpuscles of the blood. 

Some pathologists state that there is an increase of the 



6G SYMPTOMS OF INFLAMMATION. 

red globules during the very early stage of the inflammation ; 
hut all are agreed that, as the inflammation advances, these 
diminish in number, falling considerably below their normal 
quantity. 

As already pointed out, the white corpuscles are increased in the 
vessels and tissues of the inflamed part, and where the lymphatic 
system is excited by the inflammation, in the circulation generally. 

The buffy coat is always found in blood drawn from the 
healthy horse; consequently, this appearance cannot be de- 
I-iended upon as proving the existence of inflammatory disease, 
but the fibrine of the blood during the inflammatory process 
has an unusual tendency to separate from the colouring matter, 
and to the aggregation of its particles during coagulation; 
the clot or crassamentum is firmer and denser than that of 
healthy blood, and the surface is hollowed out into a cup- 
like form, in which case the blood is said to be both buffed and 
cupped. 

Much difference of opinion exists as to the production of the 
buffy coat, and I would beg to refer the reader to the observa- 
tions of Dr. Eichardson of London, Professor Lister, London, 
and others, for further information. 



TREATMENT OF INFLAMMATION. 

If the practitioner is called to a case of injury of any kind, 
his first duty is to prevent inflammation by every means in 
his power. In the case of a punctured foot, or any other in- 
jury where the cause is stiU. remaining, he has to remove that 
cause, and, by enlarging the wound, allow the escape of any 
blood or serum that may have collected around the foreign 
body, and in its immediate vicinity. He will also apply soothing 
remedies to the part,, such as warm or cold applications or 
poultices, and enjoin strict quietude. I prefer warm to cold 
applications, and recommend them strongly in the majority of 
cases. It is also a safe and commendable practice to adminis- 
ter a purgative, consisting of from four to six drachms of aloes 
in a ball : by pursuing such a line of treatment, every part of 
the inflammatory process may be averted, or at least modifled 
to a considerable extent. 

But if inflammation be fully established, and the exciting 



TEEATMENT OE INFLAMMATION. 67 

cause still remain, the duty of the practitioner is to effect 
its removal as speedily and as effectually as possible. This 
having been accomplished, the inflammation may be subdued 
by comparatively slight means, and with little danger to the 
patient. But if this important preliminary be neglected or 
imperfectly performed, the most powerful remedial measures 
may be employed with no avail. If, for example, the practi- 
tioner be called to a case of lameness caused by a foreign 
body in the foot, or by pressure of the shoe upon some one 
particular spot, he will remove that shoe or that foreign 
t>o(iy, give an outlet to the serum or pus which it may have 
created, and by a gentle purge, a poultice, and rest, dissipate 
all the formidable symptoms, the local inflammation, and the 
general fever. But, on the other hand, if he leaves the foreign 
body in the inflamed part; neglects to give an outlet to the 
discharge ; gives purgatives and sedatives ; bleeds, foments, 
and poultices ; blisters, or pursues all the most heroic methods 
of treatment — what will be the result ? Increase of the lame- 
ness, of the local inflammation, and of the accompanying 
fever; and if death of the animal does not ensue, the pus 
will force its way out at the coronet, disconnecting the hoof 
from the sensitive foot, and producing such a morbid con- 
dition of the part as may take a long time to recover. This 
is not a fanciful illustration, as the majority of practitioners 
can bear testimony, and some of them to their cost and 
annoyance. Let it be remembered that the first step in the 
treatment of every disease, whether surgical or medical, is to 
remove the cause: aU treatment is of minor importance com- 
pared with this. "Eemove the cause, and the effect will 
cease," is an old maxim which should never be forgotten by 
the veterinary surgeon. "When the cause has been as effec- 
tually removed as may be in his power, he will be in a 
position to proceed with remedial measures. Those which are 
opposed to the advance and persistence of inflammation, are 
termed antiphlogistics ; and one of the most important of 
these is blood-letting, which is of two kinds, namely, local and 
general. 

Until a recent period, bleeding was considered by almost all 
as the great thing needful in all acute inflammatory affectibns — 
that it cut short as well as cured every inflammation. I shall 



68 SYMPTOMS OF INFLAMMATION. 

now endeavour to explain the views of the old and of the new 
school of therapeutics, upon this important point. 

The Old View. — Of all antiphlogistic remedies, the most 
important was blood-letting; and the effect of general blood- 
letting in arresting inflammation was said to be owing princi- 
pally to its lessening the force of the heart's action, causing 
derivation of the blood from the part, and facilitating the action 
of other remedies. " A sedative result on the heart's action is 
effected by withdrawing from the central organ of circulation a 
part of its natural stimulus, the blood, by which its action is 
habitually maintained, and partly by the intervention of an im- 
pression produced on the nervous system ; it being well known 
that the sudden diminution of pressure on the brain and medulla 
oblongata has a remarkable effect in diminishing the frequency 
and force of the heart's action." 

Dr. Alison says: — "The effect of blood-letting in causing 
derivation from parts actually inflamed to other parts of the 
body has not been studied with so much care as might have 
been expected from the pains bestowed upon it by Haller. 
Whether this effect is, as he thought he had ascertained, in- 
explicable on merely mechanical principles; or whether, as 
Magendie and PoiseniUe assert, it is merely the effect of the 
contractile power of the vessels, and the forced state of disten- 
sion in which they exist during life, causing a flow to any 
point where an opening is made; it is quite certain that a 
movement in that direction is immediately perceived in all the 
small vessels that can be seen under the field of the microscope, 
on a puncture being made in any one of them ; and in Haller's 
observations it distinctly appeared that this movement often 
inverted the natural course of the circulation, and often extended 
to blood stagnating in vessels, and caused globules to separate, 
and become distinct, which had previously combined in irregular 
masses. This being so, it cannot be doubted that similar changes 
must be effected, in a greater or a less degree, in the blood stag- 
nating in inflamed parts, when an exit is given to the blood from 
other parts of the circulatory system, whether by general or local 
blood-letting. And it does not seem possible to understand on 
what other principle than this blood-letting can be useful, as 
it undoubtedly is, in certain cases of inflammation, chiefly ab- 
dominal, when the pulse is smaller and even feebler than 



TEEATMENT OF INFLAMMATION. 69 

natural, but becomes fuUer and stronger ; or in others (chiefly 
of the head and abdomen likewise), when it is slower than 
natural, smaU and sharp, and becomes more frequent and fuller 
after the evacuation." 

^^ The action of other remedies is facilitated by blood-letting. 
" By lessening that morbid impetus of blood and increased tone 
of the vascular coats by which, during the state of inflammatory 
fever, the natural secretions are apparently impeded, and at 
the same time promoting absorption into the blood, as loss of 
blood is weU known to do, it favours the effect of aU other 
evacuating remedies ; and further, by its precedence it renders 
certain remedies— as mercury and opium— decidedly beneficial, 
which otherwise would have proved either inoperative or abso- 
lutely injurious." 

To this view is opposed that of the late school of therapeutics ; 
and by the followers of that school it is believed that all 
bleedings and other antiphlogistic remedies are entirely opposed 
to a sound pathology. Dr. Bennett says, that when an exuda- 
tion has once occurred, in order that it may be removed, it 
must undergo certain changes or transformations, for which an 
increased supply of blood to the part is absolutely necessary; 
that blood-letting can in no way lessen the amount of blood in 
an inflamed part, or assist in the excretion of morbid products 
from the vital fluid ; that the character of the pulse cannot be 
a safe guide to the propriety of bleeding, as its condition is the 
result, and not the cause, of the inflammation; and that the 
increased throbbing and circulation of blood about an inflamed 
part is a result of the inflammatory process — a wise provision, 
as he says, of nature, to further vital changes, and one which 
ought to be assisted rather than opposed. Such are the views 
of, first, the antiphlogistic school, and, secondly, of those who 
hold that it is impossible to cut short an inflammation, and 
make it the rule of practice to further the natural changes 
necessary for the removal of the products of the inflammatory 
process. 

I must confess that I can neither assent to the views of the 
extreme antiphlogistians nor to those of the writers who con- 
demn bleeding altogether, being quite confident that I have seen 
many cases of congestive inflammatory disease cut short by a 
timely abstraction of blood. I have experience of the method 



70 SYMPTOMS OF INFLAMMATIOIT. 

of treatment that was in vogue twenty years ago, when repeated 
and heavy blood-letting was the rule, and from my recollections 
I cannot but severely censure such an irrational method. Where 
local bleeding can be effected, it is preferable in aU cases to 
general blood-letting. 

General blood-letting is commonly performed by opening 
the jugular vein in our patients. For this XDurpose a fleam is 
preferable to a lancet, for reasons that need not be discussed 
here. The operation is termed venesection, or phlebotomy. 
If the blood is drawn from an artery, the operation is called 
arteriotomy, and is best performed by a lancet. In some cases 
of cerebral meningitis, the temporal artery has been opened 
with good effect, and the wound in the skin closed by meansi 
of a pin, retained in its position by a small quantity of tow or 
thread. If the haemorrhage is not arrested by this method in 
the case of arteriotomy, a pin or needle can be placed under- 
neath the artery. By acupressure in this way, it will be most 
effectually arrested, at the cost, however, of the vessel, which 
will become obliterated at that spot. But this is of no moment, 
as the collateral circulation will be sufficient to maintain the 
integrity of the part. 

A cow requires a larger fleam than the horse. Of this fact 
the instrument maker is well aware, and the intending phlebo- 
tomist can get fleams suitable for all his patients. 

Local blood-letting is performed upon the inflamed part, ov 
as near to it as possible, and the object is speedQy to unload 
the engorged blood-vessels. It may be done by scarification, 
incision, or puncture. In conjunctivitis, for example, it may be 
drawn from the vessels of the inflamed part by scarifying the 
inner surface of the eyelids, or by opening the angular vein. In 
inflammatory disease of the foot, any quantity can be obtained 
by puncturing the coronary plexus of veins. 

When general blood-letting from the jugular is practised, the 
animal's head should be elevated, and a full stream of blood 
allowed to flow from a sufficiently large orifice in the vein. 
If this be done, a smaller amount of blood drawn will make a 
much greater impression on the pulse than when the orifice in 
the vein is small, the blood flowing in a trickling stream, and 
the head depressed. 

The question of a second blood-letting remains to be con- 



TREATMENT OF INFLAMMATION. 71 

sidered. If the blood flows freely from the vein during the 
first bleeding, and if the animal stands a fall blood-letting, 
say from five to seven quarts, without manifesting symptoms 
of syncope by sighing and sweating, he may be considered to 
have borne the operation well; but if, on the contrary, the 
patient manifests these signs shortly after the vein is opened, 
it wiU be well for the practitioner to desist from further deple- 
tion. The urgent symptoms of the disease may by the bleeding 
be relieved, but may return again after a longer or shorter period, 
and demand a repetition of the remedy ; but before this is 
done the reaction of the system generally, the local symptoms, 
and the urgency for relief, must be taken into consideration. 
If the reaction be great, and of a sthenic character, with the 
pulse full and strong, the operation may be repeated ; but if it 
be asthenic, the pulse rapid, quick, and jerking, the respira- 
tion oppressed, with partial sweats on the body, and the 
extremities cold, the bleeding is not to be repeated. The 
appearance of the blood after it has coagulated is not of very 
great service as an indication either for re-bleeding or re- 
fraining from it. The firmness of the coagulum has been 
considered as a mark of the tonic state of the system, and 
as a warranty for repeating the bleeding when the part is 
as yet unrelieved, and the reaction continues of the sthenic 
type. On the contrary, a looseness of the consistence of the 
clot is a sign of weakness, and that the bleeding should not 
be repeated. 

The proportion of serum to the crassamentum, and also its 
altered character, are arguments for or against bleeding. If 
the quantity of serum is large, the bleeding should not be 
repeated. When the properties of the serum are so altered 
that it coagulates and forms one mass with the clot, bleed- 
ing is always injurious ; and when the serum, which has little or 
no afi&nity to the red globules in health, readily dissolves them, 
it is an unerring sign that further bleeding should be avoided. 

There are many instances for not esteeming the firmness 
and dimensions of the buffed coat as an indication for bleed- 
ing, even when it has the cupped appearance; for this con- 
dition exists in many debilitating affections, more especially in 
epizootics affecting the fibrous and serous membranes ; and no 
one now thinks of bleeding in these diseases. 



72 SYMPTOMS OF INFLAMMATION. 

It is well known that the buffy or sthenic appearance of the 
blood depends greatly upon the manner in which the blood is 
drawn. If this is done in a full stream, these characters are ever 
present in the healthy horse ; but if the stream be slow, and if 
the blood runs down the side of the vessel, there will be little 
or no buffy appearance. The form of the vessel into which 
the blood is received, and its temperature, will also affect the 
process of its coagulation. Therefore, as already mentioned, the 
mere appearance of the blood is not a guide to the repetition 
of the bleeding. As a rule to be safely followed, one good 
bleeding from a strong and previously healthy patient is suffi- 
cient in nearly all cases. 

Epizootic influences are opposed to blood-letting, and in 
epizootics of all kinds, even if the temperature indicates high 
fever, above 104° ¥., we should not hastily have recourse to the 
fleam, but should remember that the disease depends on a mor- 
bid poison, has a course to run, and is not amenable to the mere 
abstraction of blood. " When the inflammatory fever has been 
insidious, so that the first stage has passed over unchecked, or 
modified by previously existing constitutional disease, or com- 
plicated with organic local disease ; or when they denote debility, 
exhaustion, or the so-called typhoid state, they generally prove 
improper cases for blood-letting, even when seen within the 
first few days." — (Aitken.) 

The next important class of antiphlogistic agents in the 
treatment of many inflammations consists of purgatives, more 
especially the aloetic in the horse, saline in the ox and sheep, 
and of jalap or castor oil in the dog. (1.) They act by remov- 
ing from and freeing the intestinal canal of accumulated food 
and faeces, or other irritating and acrid matters. (2.) They sub- 
due the inflammatory tendency by causing a discharge of a large 
quantity of serous fluid charged with albumen. They direct 
large quantities of blood to the intestinal mucous membrane, 
and they determine to the same surfaces a large amount of 
nervous influence, and thus act on the principle of derivation. 
They diminish effusion, and check the force of the heart's 
action. Aloes, in virtue of its nauseating properties, is most 
valuable. 

The use of purgatives is indicated in inflammatory fever 
arising from aU external injuries, unless they be of such gravity 



TREATMENT OF INFLAMMATION. 73 

as to necessitate the use of sHngs from the outset ; if such be 
the case, the weight of the animal being thrown upon the 
abdominal viscera, renders the use of purgatives dangerous. 
In inflammatory fever arising from inflammations of mucous 
membranes, or when at any time the mucous membranes 
exhibit signs of irritation, even after an external injury, the 
administration of purgatives, more especially in the horse, is 
contra-indicated. In thoracic affections, even when the serous 
membranes are affected, they should be given with caution, 
but they are of great service in encephalitis, hepatic con- 
gestions, &c. 

Opium. — To subdue pain and soothe the nervous system, 
there is no remedy to equal opium. Its use is of vital im- 
portance in some inflammations, especially in inflammation of 
the intestines. 

Aconite is another valuable remedy. Its beneficial effects 
are more apparent in cases of inflammation, accompanied by 
excitement rather than pain ; it improves the tone, whilst 
it diminishes the rapidity, of the heart's action. Belladonna 
is a favourite remedy with some practitioners, but it is not so 
useful as either opium or aconite ; it, however, seems to exer- 
cise a beneficial effect upon inflammations of the larynx. 

Antimony in aU its forms has no effect upon the heart's 
action in the horse or ox, but is successfully employed in the 
treatment of canine inflammations. 

Mercury is but seldom employed in the treatment of in- 
flammation; its use in botli the horse and the ox has been 
followed by alarming, and sometimes fatal, symptoms. For 
many years cases have been treated by me without the use of 
mercury, and I am of opinion that it may be excluded from the 
list of antiphlogistic remedies. 

Alkaline remedies in some manner retard the formation of 
fibrogenous elements in the tissues; they also increase the 
secretion of urine, and particularly the expulsion by this 
channel of the products derived from destruction of the albu- 
minous compounds of the body. Alkalies, having combined 
with acids in the system, generally pass out of the body as 
salts, and tend to leave behind them an excess of alkali in the 
blood. For- this reason, the neutral salts of the alkalies suit 
the lower animals, more especially the horse and ox (in which 



74 SYMPTOMS OF INFLAMMATION. 

acidity is not such a normal condition of system as in man and 
the dog). We therefore find that the nitrate of potash is a 
most valuable antiphlogistic. 

Stimulants. — ^When, after the subsidence of inflammatory 
excitement, the process of repair does not progress satisfactorily, 
when in fact it hangs fire, either from excessive severity of the 
inflammation, depressive treatment, or other influence, it may 
be necessary to have recourse to stimulants applied to the part 
itself if superficially situated, or administered internally, when 
the seat of the inflammation is beyond our reach. But stimu- 
lants, particularly alcoholic stimulants, whether wine, spirits, or 
beer, must be very carefully administered — ^particularly in horse 
practice — and only persisted in when their beneficial effects are 
perceptible. If they improve the appetite or pulse they may be 
continued, but not otherwise. 

Local stimulants to superficial parts, after the subsidence of 
active symptoms, will often promote their recovery; thus an 
ulcer or superficial mucous membrane may be touched with 
nitrate of silver or other stimulant, or stimulated with cold 
water. Where joints or synovial membranes are to be 
treated, the stimulating effects of blisters will extend to deeper 
structures. 

One other remedy in the treatment of inflammation is 
counter-irritation, and this is supposed to act by producing 
artificial metastasis, or a removal of the diseased action to less 
important parts of the body than that originally affected. I 
need not here enter into a discussion of the value of blisters 
and other counter-irritants. They are useful when properly 
applied, and very injurious, especially in the horse, when in- 
discriminately used. Their beneficial effects are most apparent 
in inflammations of the joints, superficial fibrous structures, 
and in inflammation, acute and chronic, of the mucous mem- 
branes. Their injurious effects are seen in acute inflammations 
of the serous sacs, of the pulmonary parenchyma, and in exten- 
sive diseases arising from depressing zymotic influences. 

" The more intense forms of counter-irritant treatment are so 
painful that it is well worth while to be critical as to their 
value; and it deserves more general notice than it has yet 
received, that some of the most accurate clinical observers of the 
day are profoundly sceptical on this subject. In various cases 



TEEATMENT 0¥ INFLAMMATION. 75 

of thoracic inflammation, for instance, where thousands of prac- 
titioners employ blistering as a matter of course, the unsurpassed 
authority of Professor Skoda pronounces such treatment to be 
always powerless for good, though sometimes powerful for harm. 
And probably a large proportion of treatment by long-continued 
setons and issues has subsisted, less from any sure knowledge of 
its doing good, than as a remnant of the old belief that morbid 
humours could thus be set running from the body. Assuredly 
the whole subject requires careful clinical reconsideration; 
towards which, in this place, only two suggestions are offered. 

" In the first place, particularly with regard to the uses of 
blistering, there is a source of fallacy against which the student 
will do well to guard himself. Not every cutaneous inflamma- 
tion excited for surgical purposes is intended to be counter- 
irritant and derivative. There are cases (presently to be again 
adverted to) where it acts simply as a further stimulant to the 
part originally inflamed. "When, for instance, we apply strong 
blistering fluid directly over a knee-joint with chronic inflam- 
matory effusion, the action of the irritant propagates itself, in 
lessening degrees, through the intervening small tliickness of 
parts, and sensibly affects the synovial surface ; where frequently 
at first it causes some increase of effusion ; and where at any 
rate the desired removal of fluid onlj' begins when the super- 
induced excitement has begun to subside. And it is by reason 
of this action that, with regard to superflcial parts, blistering, 
if it does not resolve the inflammation, commonly determines 
them to suppurate ; a fact, sometimes illustrated in the treat- 
ment of indolent inguinal buboes, where it may happen that 
blistering is deliberately used in order to force this alternative 
on the part, and, either by one way or the other, to bring the 
inflammation to a close. 

" Similarly, we may sometimes be proceeding rather too 
drastically when we blister the walls of the visceral cavities. I 
have often seen cerebral distress appear to be much aggravated 
by the application of a blister to the scalp ; and it has happened, 
in making the post mortem examination of a patient to whose 
abdomen a blister had been applied, to find on the inner surface 
of the abdominal wall a red patch (probably of more injected 
muscular substance seen through the peritoneum) corresponding 
to the area of blistered skin. 



76 SYMPTOMS OF INFLAMMATION. 

" In the second place, it deserves full trial whether every in- 
tense and consequently painful form of counter-irritation might 
not be superseded by the employment of other means, less in- 
tense, but more extensively applied; whether, for instance, 
ten inches of poultice may not be equivalent to three inches 
of blister, or to one inch of issue. Tor probably among the 
agencies now spoken of there is none to which we can look 
with better grounded confidence than to the diffuse local action 
of warmth, as supplied by poultices and fomentations; par- 
ticularly when it can be so administered as to affect a surface 
of skin very greatly larger than the quantity of inflamed texture 
which we desire to relieve. 

" In many chronic — probably also in some acute — inflamma- 
tions, especially in those which arise from catching cold, or 
are associated with gout or chronic rheumatism, the excite- 
ment of the entire skin by baths of hot air or hot vapour is 
often of the most striking and immediate benefit. And though 
in most of these cases the result of the exterior heat is probably 
something more than mere blood-derivation to the skin, yet not 
the less on that account are they important illustrations of 
counter-stimulant treatment. 

" Pending the better settlement of what is doubtful in the 
present subject, there are cautions which every one admits to 
be necessary if the counter-irritant treatment of inflammation 
is to succeed according to its intention. In proportion, namely, 
as the counter-irritants which we employ are of severe local 
action, we must take care — ^first, that they be not so applied as 
to involve the inflamed part in their direct irritant operation ; 
and, secondly, that they be not so applied as to aggravate any 
existing febrile disturbance." — (SiMON.) 

TEEATMENT OF CHRONIC INFLAMMATION. 

All depressing remedies are contra-indicated, and the object 
must be to rouse and stimulate, not only the part diseased, but 
the system generally, by good food, iron, quinine (and iodates, if 
there is any deposit or thickening), and by the direct appKca- 
tion of stimulants to the part itself, when superficially situated. 

It should not be forgotten, however, that all mere remedies 
are but of secondary consideration in the treatment of inflam- 



TREATMENT OF CHRONIC INFLAMMATION. 77 

mation. The removal of the cause is the first essential, and after 
this, absolute repose of the inflamed part. If these considera- 
tions are kept in view, and the practitioner is aware that the 
tendency of most inflammations is to a favourable termination, 
he wiU understand that, in many cases, the accidental sjnnp- 
toms of urgency require treatment, rather than the disease 
itself. 



CHAPTEE IV, 

FRACTURES AND DISEASES OF BONES. 

CAUSES OF FEACTDEE SYMPTOMS MODES OF UNION TREATMENT OF 

FEACTUEES COMPOUND FRACTUEES COMPOUND COMMINUTED 

FRACTURES SEPAEATION OF EPIPHYSES FALSE JOINTS AND 

NON-UNION. 

A FEACTUEE is Said to occur in three ways : — 1st. By external 
violence, operating directly upon the injured part: 2d. By 
external violence, producing such concussion upon the bone 
as not to break it where the force is applied, but at some 
other part : 3d. By inordinate action of the muscles, as ia 
broken back. But some bones are more liable to fracture than 
others. The bones of the pelvis, shoulders, thighs, pasterns, legs, 
vertebrae, and of the face and skull, seem to be more frequently 
broken than the other bones of the horse. In the dog, the 
leg and thigh bones. Although bones are fractured in animals 
of all ages, it is worthy of notice that the bones of the old are 
more readily broken than those of the young. 

Bones are rendered liable to fracture from trivial causes by a 
previously diseased condition. The navicular bone, by a peculiar 
atrophy or caries. The os pedis, by atrophy and fragility, induced 
by chronic inflammation ; and the pelvic bones, by a degenerative 
disease, partaking of the nature of fragilitus ossium and necrosis. 

A solution of continuity of bone (fracture) may be transverse, 
oblique, or longitudinal, according as it is at a right or an acute 
angle with, or parallel to, the long axis of the part of the bone 
in which it is situated. A fracture is said to be simple when 
a bone is broken at one part, without any injury of soft parts ; 
compound or open, when there is an open wound communicat- 
ing with the broken bone; comminuted, when the bone is 
broken into several fragments ; complicated, when, together 



CAUSES OF FEACTDEE. 79 

witli the fracture, there is serious injury of the adjoining 
structures, as laceration of vessels, open joint, or serious con- 
tusion of the tissues; fradv/re with wtmnd, when the wound 
does not eonamunicate with the fracture ; impacted, when one 
fragment is lodged in the other; and partial, when the con- 
tinuity of only a part of the bone is broken. This last variety 
has been called by some bending, with partial fracture, and 
by others green-stick fracture. Bending may take place with- 
out fracture, but this, as weU as bending with partial fracture, 
is very rare in our patients, although I have seen it both in 
dogs and young horses. 



THE SYMPTOMS OF FEACTtTEE. 

When fracture occurs in one or more bones of a limb, the 
symptoms are — great lameness suddenly manifested, obvious 
deformity (with some exceptions, to be mentioned), preternatural 
mobility, crepitus, and inability to bear weight upon that limb. 
These are the general symptoms; the particular ones, as well 
as the causes of the several fractures, will be hereafter described, 
and it will therefore be unnecessary to refer to them under this 
head. 

MODES OF UNION. 

The injury inflicted in a fracture is rarely limited to the bone. 
The two or more fragments, driven in opposite directions, pene- 
trate and wound the adjacent tissues, giving rise to more or less 
less haemorrhage. If the skin is broken, suppuration generally 
follows, and the repair is attended with difficulty ; but if the 
injuries are subcutaneous, and the air has no access to the 
damaged part, the repair is more easily effected. 

The extravasation of blood about fractures is not only uncer- 
tain in amount, but unequal in the several tissues. Its presence 
is useful for diagnosis, particularly in the diagnosis of fracture of 
the humerus. 

A ridiculous idea has prevailed amongst horsemen, that 
fractured bones in the horse never unite. This is incorrect, 
and, owing to the same tendency that produces splints, spavins 
&c., the process of union and repair is a very rapid and efficient 
one, provided the solution of continuity does not extend into a 



80 



FKACTURES AND DISEASES OF BONES. 



joint liaving extensive motion, and that the fractured ends can he 

kept at rest. 

An early consequence of fracture appears to be an exudation 

of lymph, which is at first dimly granular, but becomes, at a 

later period, ruddy, elastic, or moderately firm and succulent. 

It soon attains firmness, when it is called a callus. 

There are two methods according to which the callus may 
be placed. In one method the broken 
ends or smaller fragments of bone 
are completely enclosed in a new 
material ; they are ensheathed or held 
together by it, as two portions of a rod 
might be by a ring fastened round them 
both. 

The new material, in such a case, 
surrounding the fracture is termed 
" provisional," " external," or " en- 
sheathing" callus. 

In the other method the new mate- 
rial is only placed between those 
parts of the broken bone whose sur- 
faces are opposed ; between these, it 
is inlaid, filling the space that would 
else exist between them, and uniting 
them by being fixed to both (like 
the process of gluing two pieces of 
wood). Eeparative material thus 
placed has been called intermediate 
callus. In either method, there is 
usually some reparative material de- 
posited in and near the medullary 
tissue, and this is called interior 
callus. 

In fractures that occur in the lower 
animals, with the exception of those 

^J?^:■ ^•-Obli'iue fracture of f^^^^ ^^ ^j^g flxed bones, the en- 

tne tibia, with external (ensneatn- 

ing) callus, marked a and 5. The sheathing eallus is USUal. 

line extending from . indicates ^^^^ ^he researches of Hallcr, 

tne seat oi the fracture, the new 

deposit (callus) being purposely Duhamel, Hunter, Dupuytren, Paget, 
'■^'"°''^'^- and Stanley, we find that nature never 




MODES OF UNION. 



81 



accomplishes the imion of a fracture without two successive de- 
posits of callus, and Dupuytren arranged the phenomena, from 
the time of fracture to the exact and complete reunion, into five 
different periods. 

In the first stage, comprehending a period of eight or ten days, 
Mood is extravasated into the medullary canal between the 
fragments, and under the periosteum, raising up the latter from 
the bone for some distance above and below the fracture ; the 
medullary membrane becomes swollen and separated from the 
bone, and the periosteum is not only raised from the bone, but 
also becomes red, soft, swollen, and preternaturally vascular. 
The fragments of bone may thus be 
said to be surrounded with blood, 
which not only fills the medullary 
canal and space between the frag- 
ments, but also separates the latter 
from the detached periosteum. This 
blood may be organized or become 
absorbed, and liquor sanguinis effused 
into the parts at first occupied by it. 

In the second stage, comprising the 
interval between the tenth or twelfth 
to the twentieth or twenty-fifth day, 
the " tumour of callus," as it is called 
by Dupuytren, is formed. The sub- 
stance between the periosteum and 
bone is converted into a structure 
like fibro-cartilage, and within the 
medullary canal there is also deve- 
loped a fibro-cartilage, but the sub- 
stance between the fragments retains 
the appearance of coagulable lymph. 

In the third stage, extending from 
the twentieth or twenty-fifth day to 
the thirtieth, fortieth, or sixtieth day, ^^^^,^ ^j^^^^^ ^^^^ pl„g within 

according to age and strength, the the medullary canaL The plug 

fibro-cartilage between the periosteum "* °^^^^^- 
and bone, and that within the medullary canal, are both con- 
verted into bone, the external forming a ring, ferrule, or clasp ; 
and the internal a plug, or peg, filling up the medullary canal, 

G 




!Fio. 10. — ^Fracture 



meta- 



. 82 FEACTTIRES AND DISEASES OF BONES. 

and together constituting the provisional callus. The external 
ring, embracing both fragments, and the phig, within the 
medullary canal, constitute nature's provision for keeping the 
fragments in apposition and at rest. The substance between the 
fragments is, during this stage, changed into fibro-cartilage. 

In the fourth stage, extending to the fifth or sixth month, it 
is converted into bone, constituting the permanent or definitive 
callus. 

In the fifth stage, extending from the fifth or sixth month to 
the tenth or twelfth, the provisional callus, being no longer 
necessary, disappears, and the medullary canal is restored. 
Such are the views of Dupuytren ; and such is the method by 
■which fractures are repaired in the lower animals. The only 
exceptions which I have obseiTcd, have been the union of 
fractures of the lower maxillary bone, when the fracture has 
been longitudinal, and bound so firmly as to admit of no motion 
whatever between the fragments. Doubtless, the fractures of 
our patients would unite, as those of the bones of the human 
being, by the reparative material being thrown out between the 
broken ends — that is, by intermediate or permanent callus — ^pro- 
vided the parts could be kept in a state of complete repose ; but 
this being impossible, nature has provided a method by which 
they are held in a state of quietude, until the permanent callus 
is finally deposited between the broken fragments. 

The latter part of the process of repair is that of the shaping 
and the modelling of the fragments and their bond of union. 
These consist of — (1.) The removal of sharp projecting points 
and edges from the fragments ; (2.) The closing or covering of 
the exposed ends of the medullary tissue ; (3.) The formation 
of a compact external wall and cancellous interior for the new 
bone ; and (4.) The making of these continuous with the walls 
and cancellous tissue of the fragments. The first is effected by 
the absorption of the offending points and angles, and in the 
absorption of bone the earthy matters are first removed. The 
closing or covering of the parts of the broken medullary tube, 
which are exposed in fractures with much, displacement, Li 
slowly accomplished by the formation of a thin layer of com- 
pact tissue similar to that which covers the cancellous tissue at, 
the articular ends of bones. 

The callus, before ossifying, may become, according to Paget, 



MODES OF UNION. {^3 

either fibrous or cartilaginous, or may assume a structure inter- 
mediate between these, and in any of these cases ossification may 
ensue. In different specimens, or sometimes in different parts 
of the same, the reparative material has in one displayed fibrous 
tissue with a few imbedded corpuscles, like the large, nearly 
round, nuclei of cartilage cells ; in another, a less appearance of 
fibrous structure, with more abundant nucleated cells, having 
all the characters of true cartilage cells ; and in another, a yet 
more nearly perfect cartilage. Through any of these structures 
the reparative new bone may be formed. It may be formed, 
first, where the reparative material is in contact with the old 
bone, and thence extending, it may seem as if it grew from the 
old bone ; it may be also formed in the new material in detached 
centres of ossification, from which it may extend through the 
intervening tissues, and connect itself with the old bone. 

The new bone, by whatever mode it is formed, appears to 
acquire its proper microscopic characters. Its corpuscles, or 
lacunae, at first simple, round, or oval shaped, become jagged 
at their edges, and subsequently acquire their canals, which 
appear to be hollowed out in the pre-formed ibone as minute 
channels communicating with one or more of the lacunae. The 
laminated -canals for blood-vessels are later formed. At first, all 
the new bone forms a minutely cancellous structure, which is 
light, spongy, soft, and succulent, with a reddish juice, rather 
than marrow ; and is altogether like the bones of the foetus at 
their first construction. But it gradually assimilates itself 
to the structure of the bones that it repairs, its outer portions 
assuming a compact laminated structure, and its inner acquiring 
wider cancellous spaces and a more perfect medulla. It acquires 
a definite periosteum, which is at first thin and lamellar, but 
gradually assumes toughness and compactness. 

Repair of fracture by formation of a false joint is an arrest- 
ment of the process before ossification has commenced. 



TREATMENT OF FEACTUEES. 

In the treatment of a fracture, it is of great consequence to 
perform reduction as soon as possible after the injury is' sus- 
tained, in order to prevent the bad effects of continued irrita- 
tion, and before the occurrence of swelling and thickening of the 



84 FKACTUEES AND DISEASES OF BONES. 

parts wliich surround the broken bones can prove an impedi- 
ment to their proper adjustment. When swelling and tension 
are actually present, no time should be lost in vain attempts to 
allay these by means of fomentations, &c., but the practitioner 
must at once reduce the fracture — ^the horse being first placed 
in slings (see Frontispiece) — and place the limb in a steady and 
fixed position by means of splints and bandages. The source of 
irritation being thus removed, the swelling will soon disappear. 
The best material for splints is strong leather, what is called 
" bend-leather," the pieces being made sufficiently long to extend 
to a distance beyond the superior and inferior articulations of 
the fractured bones, and broad enough to envelop and enclose 
the whole circumference of the limb. Holes may be cut in the 
leather where the splints pass over any sharp eminence, as, for 
example, over the trapezium in the knee. Gutta-percha is 
recommended by some practitioners, and it answers very well, 
but I prefer the strong leather. Before it is applied, it should 
be well soaked in warm water ; when thus softened, it may be 
moulded to the shape of the limb with the greatest ease. The 
splints are to be retained in their position by bandages. When 
swelling and tension are present before the fracture is reduced, 
the splints may be maintained in position by the looped bandage ; 
which consists of strips of calico, about two or three inches broad, 
and long enough when folded double to pass round the limb, with 
a few inches of excess ; one of the ends is then drawn through the 
loop, and tied to the other. This bandage is useful when the 
degree of tightness requires to be altered, but it must be 
replaced by the common roller as soon as the swelling has 
subsided, and supplemented by one or two layers of bandages 
saturated with starch, dextrine — or what answers the purpose 
equally well, and is much cheaper — flour paste, made by boiling 
flour in water. When dry, the bandages become immoveable, 
and support the limb so effectually, that the animal soon 
puts weight upon it. In using the starch bandage, great care 
is requisite in its adjustment: it must not press unequally 
upon any part of the limb, all hollows are to be padded with 
tow, and it must never project beyond the extremities of 
the dry bandages, which should always extend below to 
the foot: or its edges, becoming hardened, may cut and 
wound the skin, causing irritation and pain; rendering the 
patient uneasy, feverish, and the limb liable to niortifi- 



TREATMENT OF FRACTURES. 85 

cation by the swelling so produced. Another method of 
bandaging is by the careful application of tarred cord to the 
whole limb over the leather, the cord commonly used for thatch- 
ing stacks answering every purpose. The animal, if a horse, is 
to be kept in a state of quietude ia the slings for a period vary- 
ing from two to three months. In foals and young unbroken 
horses, the slings must be dispensed with, and it is wonderful to 
see how carefully an animal, — gay and spirited, perhaps, before the 
accident, — ^will nurse the broken limb ; for such, in addition to 
splints, bandages, &c., a comfortable loose place, bedded with saw- 
dust, chaff, or short straw, is aU that is necessary. When the bones 
of horned cattle are fractured, they must be treated exactly in the 
same manner as those of the young horse, slings being as a rule 
inadmissible. The Itmbs of dogs when broken require nothing but 
the starch bandage, and in the course of a very few weeks they 
wiU be found completely recovered. Such, then, are the general 
principles whereby fractures are to be treated. I have had expe- 
rience in the use of the plaster of Paris (sulphate of hme) treat- 
ment, and can recommend it. It is also recommended by Mr. 
Broad of Bath, and Mr. E. Spooner Hart of Calcutta, who state 
that, if properly adjusted, it forms the best material for retaining 
fractured bones in proper position. It is applied as follows : — 
Cut thin calico into narrow slips, mix the gypsum with cold water 
to a consistence thicker than cream ; the bandage is then to be 
soaked in it, rolled up quickly, and bound round the leg, but not 
too tightly, the animal to be kept still for a few minutes to enable 
the plaster to set firmly. To prevent dogs from biting it off, Mr. 
Broad recommends that the bandage be sprinkled, before it 
sets, with cayenne pepper. Splints made of block-tin form a 
very convenient apparatiis for retaining fractured bones in their 
proper position. They are easily made to the shape and form of 
any part of the Umb, are light, easily applied, and retained in 
position by bandages. They should be rounded at their edges, 
and all spaces between them and the irregularities of the limb 
padded with tow. Mr. Eobinson, V.S., Greenock, was the first 
to suggest the idea to me. He finds them useful in broken knees, 
and other injuries where suppression of motion is desirable. 

An animal may be lame for some weeks or months after 
a fracture has united: but if no articulation is involved 



86 FEACTURES AND DISEASES OF BONES. 

recovery will gradually become complete. Some practitioners 
fire their patients for the removal of such lameness ; such prac- 
tice cannot be too highly condemned. It is useless, nay, mis- 
chievous and cruel. I wonder what would be said of a surgeon 
who fired for a broken leg ! The thing is absurd. 



COMPOUND FEACTUEES. 

By this term is meant a fracture having communication with 
the external air by means of a wound, which is produced at 
once by the same cause as that which gave rise to the fracture : 
or afterwards by one or more fragments being forced through the 
skin, or at a more remote period by sloughing and ulceration of 
the surrounding soft parts. This wound makes a most important 
difference iu respect of the danger and difiiculty of cure. There 
is apt to arise from this source violent inflammation and fever, 
terminating in profuse suppuration or gangrene. The object in 
treating such is to obtain immediate union of the wound, and 
thus convert a compound fracture into a simple one. There 
are many cases on record of a successful issue being obtained 
from the treatment of compound fracture in the horse ; but in 
the majority of cases the terminations are very unfavourable. 
If the bone projects through the wound, and cannot be returned, 
unless in the case of a valuable stud animal, the patient had 
better be destroyed ; but if treatment be determined upon, the 
first consideration is the reduction of the fracture ; this may be 
done by extension and counter-extension, aided by proper mani- 
pulation. If the fracture be transverse, these means will be 
successful; but if it be oblique, it may become advisable to 
enlarge the wound, to admit of the replacement of the frag- 
ments. In some cases, replacement cannot be effected without 
removing the sharp ends of the protruding bone with a saw or 
bone forceps. When the fracture is reduced, the edges of the 
wound should be carefully brought together, and kept in close 
approximation by means of plaster, styptic colloid, or other 
adhesive substance. 

After the use of these means, every endeavour should be 
made to moderate inflammatory action, prevent suppuration, by 
carbolic acid, or other antiseptic dressing to the wound, and 
to lessen febrile disturbance. In our patients means must be 



COMPOUND FKACTUEES. 87 

used to keep the fractured ends in their proper position, and 
splints must be applied. An aperture must be made in that 
portion of the splint covering the wound, so as to render its 
removal unnecessary during dressing, and to allow the escape of 
any discharge which may occur. By these means a compound 
fracture may be changed into a simple one — the wound uniting 
by adhesion. The constitutional disturbance must be mitigated 
by attention to the bowels (a small dose of physic may be 
given), by allowing the lightest possible diet, and by allay- 
ing the pain, if extreme, by opium ; every unnecessary move- 
ment being at the same time avoided. When immediate union of 
the wound is not obtained, the practitioner need not despair, 
provided the constitutional irritation and pain be not extreme, 
nor the discharge from the wound excessive. "When suppura- 
tion from the wound has taken place, the parts are to be 
bathed with tepid water, and the bandage over the wound 
kept constantly wet by the process of irrigation, to be described 
hereafter. No pus should be allowed to remain about the 
wound. All soiled dressings must be avoided ; the weak car- 
bolic acid solution must be applied frequently ; and in some 
cases it will be requisite to syringe any pus-containiug cavities 
with this remedy. The animal's strength must now be kept 
up by generous food ; the stable or box kept sweet and 
we]l ventilated. If due attention be paid in all these re- 
spects, a recovery may be the reward. But too commonly 
unpropitious symptoms arise about the third day after the 
accident ; the limb swells considerably ; the discharge becomes 
profuse, thin, sanious, and foetid; there is great pain mani- 
fested; the fever runs high, the breathing hurried; the pulse 
is quick, and the appetite lost. In such a case an unsuccessful 
termination may be looked for, and it is better to anticipate it, 
and save the poor animal much suffering, by ordering its de- 
struction. In horned cattle and dogs amputation has been 
performed, and the animals have gone about on three legs 
afterwards. I remember seeing a cow in a drove en route 
to London from Wales with a wooden leg, amputation having 
been performed above the knee. 

SEPAEATION OF THE EPIPHYSES. 

Before the epiphyses are ossified to their shafts, they are apt 



88 FEACTURES AND DISEASES OE BONES. 

to suffer separation from them by such accidents or violence as 
would — later in the animal's life, and when the process of ossifi- 
cation had become complete — occasion fracture. The symp- 
toms and treatment are the same as those of fracture. 



FALSE JOINTS AND NON-UNION. 

Fractured bones sometimes do not unite firmly together, their 
extremities remain quite detached, or are merely connected by a 
fibro-cartilaginous structure. 

The constitutional causes so common in man do not, as a 
rule, apply to the lower animals, but occasionally it is found 
that a condition of the osseus system, termed moUities ossium, 
and another partaking of the nature of necrosis, exist, and effec- 
tually prevent reunion of the bones. The most common cause 
of false joint is the want of, or the impossibility of securing, 
proper apposition of the fractured ends ; and its most frequent 
situation, the anterior spinous process of the ileum. Indeed, 
it can be safely said that this fracture always ends in a false 
joint. When broken, the legs of dogs are sometimes united 
in this way, even after every precaution has been taken to 
secure all the essentials of recovery. This termination of the 
healing process may be looked upon as an example of arrested 
development of the reparative material ; every part of the pro- 
cess of repair being complete except that of ossification; the 
fragments being held together by a yielding and pliant band. 

In order to secure perfect reunion of the fractured ends of 
bones, it is necessary— (Is^.) That little or no motion should exist 
between them : {2d) That there be no excess of inflammatory 
action : {M.) That there be no interposition of pieces of muscle, 
tendon, or necrosed bone between the fragments; and (Uh) 
That there be a proper supply of blood to the part. Curling, 
Guerton, and others have paid attention to this subject, and 
have shown that non-union, as weU as atrophy of bone, may be 
due to defective supply of blood, caused by rupture of the 
nutrient artery of the broken bone. 

It is found that if the supply of blood be cut off by injury 
to the nutrient artery, so that the periosteum has exclusively 
to supply the blood, either one or both of the fractured 
pieces become atrophied, and their cancellated structure and 
walls thinned. While writing this paper, I had an oppor- 



FALSE JOINTS A.ND NON-UNION. 89 

tunity of seeing a case of non-union of the pelvic bones in a 
healthy animal. The bones were in apposition, the fracture 
being an oblique one through the shaft and spine of the ileum. 
Two months after the accident, the bones were moveable and 
crepitant ; there were no inflammatory signs nor pain present, 
the animal being in the best of health and spirits, but lame. 

Treatment. — An ingenious method is recommended by Mr. 
Syme : — " This method was devised by Dr. Physick, of New 
York, in 1804; and it consists in passing a skein of silk or 
cotton between the extremities of the bone, and allowing it to 
remain until it appears that new bone begins to be formed, 
when it may be withdrawn and splints applied." Another plan 
consists in drilling holes in the fragments with the ordinary 
Archimedean driU, and fixing them in apposition by ivory pegs 
driven into the drilled holes. I think this method deserving of 
trial in compound fractures, even in the earlier stages. The 
pegs must not project from the surface of the bones, but must 
be cut off level, so that they do not wound the soft structures. 

Blisters over the seat of fracture may be tried. They may, 
by causing the production of a fibrinous exudate, set up the 
healing process, which may ultimately end in complete con- 
solidation of the disunited fragments. 

One more method may be mentioned, namely, that recom- 
mended by Miller. It consists in introducing a long needle 
through the skin, passing it into the false joint, and cutting 
up the ligamentous bond of union, as well as the self-investing 
tissues on the bones ; covering the opening with collodion and 
plaster, and keeping the fragments at rest. 

There is great danger in allowing an animal to use his 
limb too freely soon after the apparent union of a fracture ; as 
gradual yielding of the bone may take place, and deformity 
occur from the weight thus thrown upon the limb ; hence the 
starch bandage should be retained for a considerable time, and 
the animal kept in a box for three or four weeks after his 
removal from the slings. The loose box will be better than 
the stall, as the animal will be able to take some little exercise, 
and thus allow, as it were, of passive movements of the limb, 
which will prevent thickening, or adhesion of the tendons to 
their thecse. 

When a fracture fails to unite, the causes of such non- 
union may be looked for in a variety of circumstances ; but the 



90 TEACTUEES AND DISEASES OF BONES. 

most common of these, in the lower animals, is the inability 
to prevent motion in the limb. Temperament has much to 
do with this. A calm, good-tempered horse may make a 
good recovery, whilst an irritable, fretful animal wiU keep an 
injured limb in a state of continual motion, will take un- 
kindly to the slings, and thus render union an impossibility. 
In addition to or independently of this want of repose, even 
in a simple fracture, a piece of muscle or other soft tissue 
may be imprisoned between the broken ends of the bones, 
and if this is not removed, union is not likely to take 
place. When a fracture is obliq^ue, this complication is not 
at aU uncommon. 

When a fracture is comminuted, and a large portion of bone 
denuded of its periosteum, it can be easily seen why union does 
not take place. Necrosis of the fragments will be almost sure 
to occur, leading on to suppuration, loss of substance, and the 
exhaustion of the patient. 

Again, if the violence causing the fracture be very great in- 
deed, the vitality of the surrounding textures may be destroyed, 
or the non-union may proceed from impaired vitality of the 
bone itself; and this may arise from the nutritious artery of the 
bone being implicated. In such a case, union of the deep-seated 
parts of the fracture would be very improbable. 

Surrounding circumstances and food have an effect upon the 
repair of fractures. Where stables are overcrowded and ill 
ventilated, necrosis and suppuration will most likely occur ; and 
if these be associated with improper food, it will be useless for 
the practitioner to undertake the treatment. 

I have seen cases where union of the pelvis did not com- 
mence until the food had been changed. If it be possible to 
give green food, it should always have a preference over all 
other; failing this, carrots, potatoes, or turnips should be allowed, 
in addition to hay and corn. 

The constitutional causes of non-union are those of a de- 
bilitating nature, arising from old age, hard usage, or disease. 
If a great number of horses are stabled together, no matter how 
good the ventilation, drainage, food, &c., may be, a peculiar taint 
is often produced upon their constitutions by an animal malaria, 
causing a cachexia, or condition of body in which the reparative 
powers are in a depressed and languid condition ; in such the 
repair of fractures is effected with difficulty. 



CHAPTER V. 

PARTICULAR rEACTURES. 

FHACTURES OF INFERIOR MAXILLA FRACTURES OF ANTERIOR MAXILLA 

AND OF OTHER FACIAL BONES FRACTURES OF CRANIAL BONES 

^FRACTURE BY " COUNTER STROKE" CONCUSSION OF THE BRAIN 

HERNIA CEREBRI. 

FEACTUEES OF THE INFERIOR MAXILLARY BONE. 

1st. Compound fracture through the symphysis maxillaris, 
resulting from an animal falling upon the mouth. The direction 
of the fracture is longitudinal, involving the alveolar cavities of 
one or more incisor teeth, and extending through and termina- 
ting in the maxillaiy space ; or obliquely, from the centre out- 
wards, through the neck of one or both rami. 

Treatment — Fracture through the Symphysis. — Eemove loose 
teeth and foreign bodies ; search for any loose pieces of bone, 
and remove them. When this is done, it will be found that 
the fragments can easily be brought into apposition by a little 
pressure, and so maintained by means of copper wire bound 
firmly round the incisor teeth. If the animal be a male, the 
tushes may be included in the wire. A calico bandage may 
then be applied, for the purpose of further strengthening the 
parts, and keeping out foreign bodies from the wound. Let 
the animal be kept upon soft but nutritious food ; the wound 
looked to occasionally, and washed out with a solution of carbolic 
acid to destroy the fcetor which is sure to be present. In the 
course of three or four weeks the fracture will be found re- 
united. 

If the practitioner suspects that any necrosed portion of bone 
exists in the wound, he must search for and remove it. Its 
presence may be suspected by a foetid, purulent, sanious dis- 



92 TilKTICJLAE FEACTUEES. 

charge taking place from the wound, and by the animal not 
making that progress towards recovery which he has a right to 
expect. 

2d. Superficial fractures of the lower jaw occur from severe 
curbs and bits ; anteriorly and within the mouth from the bit, 
posteriorly and under the jaw from the curb. 

Symptoms from Injury of the Bit. — Dribbling of saliva from, 
or foaming in, the mouth ; the animal shy or perhaps vicious if 
the mouth is touched ; inability to bear the introduction of the 
bit ; difficulty in masticating food ; perhaps haemorrhage from 
the mouth, or saliva streaked with blood. Upon examination, 
the buccal membrane will be found bruised, inflamed, and 
swollen, with perhaps a piece of bone sticking through it. 

Treatment. — Eemove the small fragments. As the fracture is 
superficial, no bandaging is required ; but the animal must not 
be bitted until the parts are completely healed and hardened, 
or he will have a bad or weak mouth ever afterwards ; indeed, 
some horses that I have seen never aUow a bit to be put into 
their mouths again without great struggling and resistance. 
The animal should be fed upon soft diet for some days after 
the injury, and the wound examined occasionally, as portions 
of bran, hay, or corn are apt to lodge in it, causing irritation, 
and retarding the healing process. If the wound discharge 
a foetid material, it should be syringed with a weak solution of 
carboUc acid ; in any case, the mouth may be washed with this 
two or three times a day. 

Symptoms from Fracture hj the Curl. — Swelling and tender- 
ness of either ramus immediately in front of the curb ; sinuses 
shortly form, and within them loose pieces of necrosed bone 
may be detected by the probe. The discharge is curdled, 
foetid, but not very profuse. In some of these cases there is 
no primary fracture, but necrosis of the superficial layer of the 
bony tissue, arising from continued and severe pressure, pro- 
ducing periostitis, gangrene of the periosteum, and death of the 
bone, from the pressure, and non-supply of blood to that part of 
it covered by the gangrenous periosteum. In other cases a bony 
tumour forms here as a result of periostitis, and of increased 
thickness of the superficial layer of the bone (hyperostosis). In 
the first and second forms of injury, it is necessary to remove 
the fragments of bone, whether they are necrosed or not. It is 



FEACTUEES OF THE FACIAL BONES. 93 

waste of time to allow them to be removed by exfoliation. 
The method which I recommend, is to slit up the skin, and 
carefully scrape the diseased surface. If this be done, the cure 
may be effected in a very short time. If the necrosis is very 
superficial, one or two applications of dilute hydrochloric acid 
wiU effectually remove it, and render unnecessary the perform- 
ance of an operation. Common sense will convince the reader 
that the cause, namely, the severe curb, must not be again 
applied. 

In the third form of injury, namely, the hyperostosis, aU the 
the treatment necessary is the removal of the cause, and the 
application of soothing remedies, succeeded by frictions, with 
iodine ointment. 

2d. Fractures of the inferior maxilla occur at the boundaries 
of the alveolae of the incisor teeth by the forcible " punching 
out" of the temporary incisors — more especially the corner 
bones. This cruel procedure is resorted to for the purpose of 
making the animal appear older than he really is. It cannot 
be too highly censured, and no veterinary surgeon should 
ever be guilty of doing such a thing. It can in no way benefit 
the horse, and the idea that the removal of the temporary teeth 
hastens the development of the permanent ones, is founded on 
the grossest ignorance. Doubtless, the permanent teeth are 
sooner brought into view. This, however, does not arise from 
any increase of their growth, but from the removal of the mem- 
brane by which they are covered. Still, when the bones are 
fractured, the veterinary surgeon must give relief as speedily 
as possible. All loose fragments of bone must be removed, and 
the wounds washed out. Occasionally, the gum and membrane 
of the mouth will be found torn to a considerable extent — the 
ends hanging loosely in the mouth. These must be brought 
together, and secured by suture. After this is done, all that 
is necessary is to cleanse the mouth occasionally with a weak 
solution of chloride of lime or carbolic acid, and to place the 
animal on soft diet. 

4 th. Fracture of the rami of the lower jaw may occur from other 
causes than that of the horse falling upon his mouth — such as 
kicks from other horses, or any other external violence. The 
fracture may be in front of, posterior to, or in a line with the 
tush. If the tush is loosened, it must be removed; but this 



94 PARTICULAR FRACTURES. 

is not to be done unless it is loose, as it may be of great service 
in securing the bone in its position, as already shown. The 
presence of such a fracture, if simple, will be indicated by 
tenderness, and perhaps crepitation ; if compound, its condition 
is detected by exploration of the wound. If the- fracture extends 
through the jaw, with displacement, there wiU be deformity, in 
addition to the other symptoms. 

I have never seen a simple fracture of this part, but such a 
thing may occur ; the most common form, however, is that of 
a compound comminuted fracture of the external surface only ; 
the alveolus and contained tooth, by breaking the concussive 
shock, prevent the fracture from extending to the internal 
surface. Presuming, however, that the fracture is complete, 
it may be single or double, with displacement. If simple, 
replacement, adjustment, and retention of the disunited parts 
in their proper position are the means to be resorted to; if 
compound and comminuted, the removal of all loose fragments 
must be the first proceeding. In order to do this effectually, 
it will often be necessary to enlarge the wound, and, provided 
there is no previous disease of the bone, a cure may confidently 
be looked for. 

When the broken ends are brought together, means calculated 
to retain them in their proper position must be resorted to. 
If the injury is near the symphysis, the copper wire and band- 
ages already recommended will be sufficient ; but if situated 
posterior to the tush, something more than this is required. 
Professor Varnell, in the Veterinarian for 1866, recommends 
a cradle made as follows : — " The cradle will be from fifteen to 
eighteen inches long ; it should extend as far back as the angle 
of the lower jaw, and as far forward as to be within an inch of 
the anterior margin of the lower lip. Its sides should turn up, 
so as to embrace the outer surfaces of each branch of the bone, 
and be on a line with the upper margin of the under lip, beyond 
which they should rise to within a short distance of the zygo- 
matic ridges. Posteriorly, it should incline, up wards and back- 
wards ; the centre of its xmderneath surface should be pushed 
upwards, forming thereby a ridge, which is to fill up the space 
between the rami as far forward as the symphysis of the jaw- 
bone. Its angles must be rounded off, and its borders perfor- 
ated by holes or slits, so as to enable the operator to apply 



FACE CEADLE designed by Me. WALKER, V.S, Beadford. 

Fio. I. 




1. Padding to protect the poll. 

2. Brow band. 

3. Throat lash. 

4. Pad for submaxillary Bpace — to be made of wood, and well padded 

with leather. 
5-5. Flanges to rest on first molars. 
6. Supplementary strap slits. 
7-7-7-7. Straps — which all pass under the lower jaw. 

8-8. Thumb-screws for lengthing or shortening the plate, designed by Mr. 
Bboad, Bath. 



FRACTUfiES OF THE FACIAL BONES. 95 

straps, &c., to secure it in its place. If straps are used, they 
may be placed as follows : — One may pass from a little below 
the supero-posterior angles round the back part of the horse's 
head, behind the ears ; a second, from the upper borders of the 
cradle, a little in front of the supero-posterior angles. This 
should pass across the brow, in front of the ears. A third, a 
small strap, may pass from one of the two straps to the other, 
between the ears. A fourth may proceed from the middle of 
the upper borders of the cradle, across the front of the face, a 
little below the orbits ; and a fifth may pass across the nasal 
bones, sufficiently above the nostrils, not to interfere with the 
horse's breathing. The two last-named straps should be partly 
elastic, the last one more so than the other, so as to allow the 
horse to open his mouth to a slight extent. 

" Should the fracture be compound, some holes will be required 
in the cradle opposite to the seat of the injury. Perforations 
of this kind can be made after the cradle is manufactured. 

" As horses' heads vary both in size and form, it is not to be 
expected, even though a practitioner has two or three of these 
cradles on hand, that any one of them will fit the parts with 
that exactness he could wish. The inequalities, therefore, must, 
as before stated, be filled with a padding of tow, or some other 
agent, in addition to that which should, on all occasions, be 
used as a lining to the inner surface of a cradle or splint. 

" He who is called upon to treat a case of fracture of the lower 
jaw of a horse must not despair if he does not possess any other 
splints than those he is obliged to make at the time. The 
principal object, after the ends of the broken bone are brought 
in apposition, is to retain them there until they are united ; and 
the practitioner should endeavour to accomplish this with as 
little inconvenience to the horse as possible." 

The method recommended by Professor Vamell seems com- 
plicated, but coming from such a source, it deserves every 
respect. Mr. Walker, V.S., Bradford, has designed a cradle, 
which has answered the purpose very well in at least two 
cases, where the fractures were posterior to the tushes, and in- 
volving both rami. He has kindly sent the following drawings 
of it. — {See Engravings.) 

The tendency of the fractured ends to fall inwards is the 
only real obstacle we have to contend with ; so if we can by 



96 PAETICULAR FKACTUEES. 

any method fill up the submaxillary space, we shall overcome 
this difficulty. The pad (a) in Mr. Walker's cradle answers this 
purpose ; and the flanged plates (6) resting on the molar teeth 
render displacement of the fragments almost an impossibility, 
whilst every freedom is allowed to the natural movements of 
the jaw. 

It must be borne in mind that the adjustment of the fractured 
parts must be made with great care, in order that the molar 
teeth may meet those in the upper jaw as evenly as possible ; 
otherwise the process of mastication will afterwards be imper- 
fect. If any teeth are loosened in their sockets, they must be 
removed, as they, by acting as foreign bodies, and preventing 
the proper adjustment of the fractured ends of the bone, retard 
the process of union. In addition to these means, the unin- 
jured teeth may be fastened together by the copper wire. If 
the injury has been in existence for a day or two, with swell- 
ing, and perhaps systemic disturbance, it will be necessary to 
remove these symptoms, as well as to adjust the broken bone. 
Apply fomentations to the part, and give a dose of- purgative 
medicine. Motion of the jaw must, for some days, be prevented 
as much as possible, supporting the animal during this time by 
a loose, nourishing diet, such us bran-mashes, boiled linseed, and 
gruel. If the formation of callus seems retarded from any cause, 
milk may be allowed — of which the horse will drink freely — and 
thick oatmeal porridge. In fact the strength of the animal must 
be kept up without causing the jaw to perform any hard labour. 
The practitioner will at once see the importance of this. There 
is one other thing in connection with the treatment of all kinds 
of fractures of the bones of the mouth that I must insist upon 
as being most important, namely, that all food be given in a 
wide-bottomed and shallow manger or tub. If the manger is 
narrow and deep, displacement of the bones, from the etforts of 
the patient to get at the food, is sure to result. 

All pieces that are separated from the body of the bone, as 
well as those denuded of periosteum — even if attached by one 
end — partly split off, as it were — must be removed, either 
with the common or bone forceps ; and the wound must then 
be covered by fine tow dipped in a weak solution of carbolic 
acid ; a hole, as already described, being left in the mould for 
the purpose of renewing this dressing, and for cleansing the 



o 

PQ 

02 



M 

t 

Q 

02 

o 
1-1 



o 
o 



HI 




=§ a 



SI ^ 






■i S 

2 S 






^ 3 . 

2 "3 -a 

2 -^ n 
:S ►« .S 









« 



1^ 



|<3 

l-l ^ ^ 



a, 
i 






FACE CEADLE designed by Me. WALKEE, V.S., Beadfoed. 

Fia. III. 




FiouBB III. shows the apparatus fixed on the head. For a smaller head it is 
necessary to shorten the apparatus by turning the thumb-screws, as, if it extended 
beyond the muzzle, the patient would be unable to feed. 



FRACTUEES OF THE FACIAL BONES. 97 

'wound, if necessary. It is found, since the introduction of 
antiseptic surgery, that the wound often remains dry, and that 
it heals by the adhesive inflammation. If such be the case, 
the dressing must on no account be interfered with, and means 
must be taken to keep it in its place, either by the applica- 
tion of collodion, styptic-colloid, or gutta-percha paste. When 
a loose portion of bone remains, its presence may be detected 
by the continued foetor of the discharge, and by an ulcer in the 
skin communicating by means of a sinus with the bone 
within. In all cases where a loose piece of bone is found in 
the part some time after the accident, it will be advisable, if its 
removal is not easily accomplished, to allow some weeks to 
elapse before forcibly extracting it, in order that the union and 
consolidation of the fracture may be complete. The opening in 
the skin may then be enlarged, and the necrosed bone removed 
by the forceps or tenaculum. 

No alarm need be felt at the foetor of the discharge during the 
first few days after the accident, for as a rule this is always pre- 
sent. The discharge is at first thin, dark-coloured, and foetid ; 
but if not too profuse, it does not indicate any serious results, for 
it very shortly becomes lighter in colour, less offensive in odour, 
and partakes more of the nature of laudable pus. Every facility 
must be given for the discharge to drain away, and the wound 
may be injected witli a weak solution of hydrochloric acid. I 
recommend this in preference to all other dressings in such 
cases, as it dissolves the earthy matters of the necrosed sur- 
faces of the bones, and thus facilitates the formation of a healthy 
healing surface. I have used it for years, and can speak most 
highly of it. Much pain is manifested by the animal in some 
cases of this kind of fracture, from the inferior dental division 
of the posterior maxillary branch of the fifth nerve being in- 
volved in the injury. In such, much relief will be given by 
dressing the wound with a solution of morphia, or by the ad- 
minstration of opium : the local application is the better practice, 
and as little medicine as possible should be given after the 
first dose of physic, for fear of causing displacement. If the 
bowels are constipated, enemas ought to be administered, and 
the food should be of a laxative nature — linseed, bran, boiled 
turnips, or (3arrots; or what Mr. Anderson, V.S., Glasgow, 
recommends — linseed oil in a warm bran-mash. The patient, 

H 



98 PARTICULAE FEACTUEES. 

as a rule, will eat it. Gentle exercise is to be given from day 
to day ; and in order to prevent the patient eating the bedding, 
it should have a loose box littered with sawdust. In about a 
fortnight after the accident, if the case does well, chopped hay 
may be allowed, with boiled oats and bran. I have heard of a 
case of fracture of the condyle of the lower jaw, with open joint, 
and that the patient recovered, with perfect motion in the 
articulation. Such a thing may be possible, but is scarcely 
credible. 

Fracture of Anterior Maxillary Bone must be treated in 
the way already laid down — that is, by the copper wire and 
bandage. 

Fracture of the Nasal Bones occurs rather frequently, from 
runaway horses coming in contact with hard substances, such as 
lamp-posts, &c. As a rule, one of the bones is fractured, but 
occasionally both are found broken. In old horses these bones 
are much more easily fractured than in young ones, for the simple 
reason that their great elasticity in the young enables them to 
bear and resist violent shocks of concussion. These fractures 
may be complete, or partial only, — in the latter case the outer 
plate of the bone being broken, and the inner bent in without 
being fractured. When it is complete, it will be found that 
the Schneiderian membrane is lacerated, with perhaps sharp 
fragments of the bone sticking through it. This will be more 
particularly the case in the lower portion of the nose. If the 
lesion is at the upper part, the fragments wiU be driven into 
the facial sinuses. The symptoms of fracture of these bones 
will be depression; hemorrhage from the nose; and if the 
depression is extensive, the breathing will be impaired by the 
inward bulging of the displaced bones. I remember a case 
where this impairment was a permanent unsoundness. The 
fracture was an old one, when seen by me, with considerable 
depression upon the front of one nostril. When the horse was 
quiet there was no noise in the breathing, but when put to 
work, there was a sound emitted during both acts of respira- 
tion, accompanied occasionally by haemorrhage. The case was 
tried at the Halifax County Court; Mr. Dray, of Leeds, and 
myself certifying to the unsoundness of the horse; the Judge, 
Mr. Stansfield, concurring, and giving judgment accordingly. 

In the treatment of this fracture, whether it be simple or 



FRACTURES OF THE FACIAL BONES. 99 

otherwise, an endeavour must be made to readjust the bones in 
their prdi)er position. Professor Varnell recommends that " a 
piece of wood should be prepared, about one and a half inches 
wide, about half an inch thick, and of sufficient length for the 
purpose. This piece of wood should have its angles rounded 
off, and that part of it which is required to be passed up the 
nasal passage should be covered with a piece of thin wash-leather, 
to prevent the possibility of any splinter injuring the mucous 
membrane. The operator being thus provided, and the horse 
favourably placed and secured, this rude instrument is to be 
passed up the nostril of the side affected, as far as a little 
beyond the seat of the fracture, when as much force as may be 
necessary, or deemed prudent, should be used to raise the de- 
pressed fragments of bone. If the fracture is compound, 
and any portion of the bone projects through the skin (which 
is not very likely to be the case), it must be dealt with as 
recommended in compound fracture of the lower jaw; or if it is 
comminuted, and a fragment is found to be wholly detached, it 
should be removed with the forceps. 

" The segments of the fractured bone having been adjusted 
as nearly as possible in their proper position, means should be 
devised to retain them there. For this purpose two modes 
suggest themselves. The first is as follows: — To clear the sldn 
as much as possible from dirt and other extraneous matter, 
and when it is thoroughly dry, to place some straps of strong 
adhesive plaster across the fractured bones. These should be 
carried a little beyond their outer boundaries, and in such direc- 
tion as may be thought best. 

" These straps, if weU applied, will be found to answer a very 
good purpose, especially when the bone is much splintered or 
the skin penetrated, as in compound fracture. In the latter 
they win close the opening, and thus to some extent reduce 
it to a simple one ; they wiH also materially support the broken 
bone, and thus prevent any portion of it from falling into the 
nasal passage or the nasal sinus. 

" The other mode of keeping the fractured bone in its proper 
position, which may be used with or without the former, and 
which also tends to arrest haemorrhage, should it exist to any 
extent, is to plug the nasal passage with fine tow or cotton wool. 
This may be done in the following way with perfect safety : — 



100 PARTICULAR FRACTURES. 

" A piece of soft but strong twine may be firmly tied around 
a small bundle of the above agents, which should be sufficiently 
large to fiU the passage. The free end of the string should be 
long enough to reach some little distance out of the nostril, 
whereby the operator may be enabled to hold it firmly while 
the rest of the passage is being plugged. 

" By this arrangement the whole of the plugging can be re- 
moved at any time that may be deemed advisable, and there 
will be no danger of any portion of it passing in a backward 
direction through the posterior nares into the fauces. 

" There need be no apprehension about the horse's breath- 
ing being interfered with, if one of the nasal passages only 
is plugged ; but I need not say that both should not be so 
treated, as the horse cannot breathe through his mouth." — 
(Professor Vaenell, in Fe<«rma9'wn., November 1866, pp. 875-6.) 

If this method should be found impracticable, and more 
especially if the fracture is a compound one, the broken bones 
should be raised from the outer surface by means of a strong 
tenaculum or hook, which is easily introduced into the edge 
of the fracture J the parts must afterwards be strapped, as 
recommended above, and in all cases the patient must have rest. 

Should the discharge from the nose, which is always sure to 
succeed the haemorrhage in this kind of fracture, continue, and 
become more profuse, foetid, curdled, or sanious, a search must 
be made for any detached ' piece of bone which may exist in the 
part ; when found, it must be removed, and the portions of 
healthy bone in contact witla it dressed with the dilute hydro- 
chloric acid, as the mere contact with necrosed bone is apt to 
cause a necrosed or carious condition of the edges in such 
contact. 

Horses have been condemned for glanders while only suffer- 
ing from the presence of loose pieces of fractured bone in the 
nasal region, and it is maintained by some, that fracture of the 
nasal bones is of itself sufficient to produce glanders; but I 
cannot conceive how a disease due to a specific virus can arise 
from a mere accident, although the discharge, ulceration, &c. 
may closely resemble the specific disease. To remove foetor, 
and to promote a healthy condition of the mucous membrane, 
the nostrils may be daily syringed with very dilute carbolic 
acid, solution of chloride of lime, Condy's fluid, or by insufflation 
of iodoform. 



nUCTUEES OF THE FACIAL BONES. 101 

Fractures of the Superior Maxillary Bone are generally 
caused by blows upon the face with the butt- end of the whip, 
given by a bad-tempered and savage horseman. As a rule, 
these fractures are situated anterior to the maxiUary spine, and 
immediately over the superior maxillary sinus, into which the 
fragments fall. The fracture is usually compound and com- 
minuted, and is easily diagnosed by the egress of the air 
expelled by the patient during each time of expiration. 

Treatment. — ^Eemove all loose portions, bring the edges 
of the wound together by suture, and apply the collodion 
dressing. 

Tlie Frontal Bones are broken by falls and other severe 
accidents; the seat of the fracture is usually found in the 
orbital process. The anatomist knows that the frontal bones 
enter into the formation of both cranium and face. If the 
facial portion be fractured, there is but little danger of imme- 
diately fatal results ; but if the cranial portion is thus injured, 
death may be instantaneous, particularly if the blow has been 
sufficient to fracture both plates of the bone. Occasionally, but 
very rarely, the orbit is pierced by a sharp-pointed instrument, 
and the orbital plate, which is thinner than any other portion 
of the cranial bones, is penetrated, and the brain seriously 
injured. In the most usual form, namely, fracture of the orbital 
process, it is obvious that many important organs contained 
within the cavity of the orbit may be seriously hurt, such as 
the supero-orbital division of the fifth nerve, its accompanying 
artery, lachrymal glands, and even the eye itself. Sometimes a 
small piece of the anterior border is, as it were, chipped off, 
and the tarsal ligament detached from it, which makes the case 
dif&cult to manage. 

Professor VarneU says that "there is a great tendency in 
this part of the bone, when injured, to ulcerate and crumble 
away." I have not observed this; but it may be due to the 
circumstance that I make it a point in practice never to allow 
detached fragments of bone to remain in the wound. When 
the orbital process is completely fractured — say a simple frac- 
ture from a severe blow with a blunt instrument — the fractxired 
ends are driven inwards by the force of the concussion. In 
such a case, the eye will be completely closed ; and if there be 
no swelling or bruise, the closure of the eye is the only symp- 



102 PARTICULAE TRACTUKES. 

torn of the injury : there is both paralysis and mechanical dis- 
placement of the eyelid. 

The treatment of such a case is to elevate the depressed ends 
of the bone ; and to do this it may be necessary to introduce 
a small lever under the skin, making the incision through 
which it is to be passed close to the zygomatic ridge, and 
pushing the instrument subcutaneously until the seat of the 
fracture is reached, when the elevation may be effected ; if 
the lever is put under the centre of the depression, both ends 
may be elevated simultaneously. Considerable force is neces- 
sary, but it must be applied carefully and steadily. Let there 
be no jerking, but steady, continued pressure. I have seen the 
eye recover almost its natural shape when this has been done. 
Little else is required locally ; the animal is to be kept at rest, 
the wound made by the operator covered over with collodion, 
and low diet prescribed ; a dose of physic may be given, and the 
animal carefully watched for a few days by the veterinary 
surgeon, who will adopt such treatment as may be suggested by 
the symptoms. If the fifth nerve be damaged, there is found 
to be a tendency to tetanus ; all causes of excitement must 
therefore be guarded against. 

Should the fracture be compound or comminuted, the treat- 
ment already laid down must be employed. 

The outer plate may be fractured over the centre of the 
frontal sinus ; it may be merely bent inwards, from partial 
fracture ; or it may be completely shattered, and the skin 
penetrated. 

If there be mere depression, there should be no interference, 
as the indented bone wiU not press upon any organ, and the 
only results will be a slight blemish externally, and diminution 
of the sinus within. A dose of physic should be given — febri- 
fuges if necessary — and a short period of rest allowed. 

But if the injury has penetrated the skin, and broken the 
bone into fragments, it becomes the duty of the veterinarian to 
remove all such fragments, whether they are attached to the 
fractured borders, or have been forced into the cavity; to 
thoroughly cleanse the sinus from all clots of blood and other 
foreign bodies ; for if these remain, their decomposition wiU be 
productive of much mischief. "When these things are done, 
the forehead is to be strapped with pitch-plaster, and the con- 
Btitutional treatment above described adopted. 



FEACTUEES OF THE FACIAL BONES. 103 

The liffimorrhage may continue for some hours after such an 
accident, and, of course — from the sinus being continuous with 
the nasal cavity — the blood wiU flow through the nostril. This 
need occasion no alarm ; the pouring of cold water, both into 
the sinus and on the face, wiU generally arrest it; or two 
ounces of the tincture of terchloride of iron may be mixed with 
a bucketful of water, and syringed iato the wound by means 
of an elastic enema syringe. 

I do not recommend the application of poultices to injuries 
of this kind, nor disturbance of the parts after the first dressing, 
which must be effective and complete ; but should the swelling 
become excessive, or a purulent discharge manifest itself, it 
becomes a duty to apply fomentations of warm water in which 
a little carbolic acid has been dissolved, and the general treat- 
ment of wounds which wOl be hereafter laid down must be 
resorted to. If at any time the wound assume an unhealthy 
character, with a thin foetid discharge, caries of the bone is 
indicated, and this wiU require the hydrochloric acid dressing, 
care being taken that the diseased bone receives the application. 
It must never be forgotten by the practitioner thai; an injury to 
any part of the cranium may be much more serious than may 
at first appear. The effects of the shock, although this is pro- 
vided for by the double layer of bony plates, may scarcely be 
apparent; but unexpected symptoms may arise, indicative of 
severe lesions to the brain and nervous system. 

Fracture of the immediate walls of the cranium may be pre- 
sent, involving the vessels of the brain, and when such is the 
case, the termination is generally fatal. 

I have seen the zygomatic ridge broken on its outer edge, 
the fragments remaining in the wound, and requiring re- 
moval. 

I have little to add upon fracture of the facial bones. Any 
of them, where they are exposed to external influences, may be 
fractured; and should such fractures involve organs or vessels 
of importance, the case becomes the more complicated. For 
example, the lachrymal duct may be involved in fracture of the 
bone of the same name ; the fractured bone may heal, but the 
duct wiU be spoiled; and the lachrymal secretion, instead of 
being discharged into the nostril, wiU flow over the face. 
Again, the parotid duct may be opened in a fracture of the 



104 



PARTICULAR FRACTURES. 



lower jaw, or the inferior maxillary division of the fifth nerve 
may be injured and pressed open by a piece of depressed bone, 
causing excruciating pain, and even fatal results, if not at once 
removed. 



FRACTURES OF THE CRANIAL BONES. 

By the arrangement of the cranial bones, an ovate box in 
formed, which resists external violence after the manner of an 
arch ; yet it is sometimes fractured by the direct application 

of force to the fractured parts, but 
more frequently — in the lower ani- 
mals, especially in the horse — at a 
part of the skull distant from the 
place where the violence has been 
received. This is called " indirect 
frachore,'' or fracture hy counter- 
stroke, or what is termed by the 
French, fracture 'par contre-coup. 

Fractures of the base of the skull 
are, in all instances, caused by the 
indirect application of violence, and 
this is easily explained. If a horse 
fall, or be struck heavily by a blunt 
instrument or obtuse body, upon the 
occipital crest, the force thus applied 
is resisted by the strength and thick- 
ness of this part of the bone, and the 
shock is conveyed to the basilar 
process, this being its weakest part. 
In all cases this form of fracture 
is necessarily fatal. 

Sometimes the violence of the 
fall or blow is sufficient to produce 
fracture of the part to which it is 
applied, and also to extend to the base of the cranium. 

The fractures of the cranium may be conveniently arranged 
as follows : — 

Is*. Simple fissure or fracture without depression. 
2d. Simple fractures with depression. 




Fig. 11.— Indirect comminuted 
fracture of basilar process of occi- 
pital and sphenoidal bones, from 
falling on occipital crest, a, Gooi- 
pitaL J, Sphenoid. 



FEACTUEES OF THE CKANIAL BONES. 105 

3d. Punctured fractures. 

4:th. Compound fractures. 

5th. Fracture of external table only. 

6th. Fracture of the internal table only. 

1. Simple Fissure. — In this form there is no wound of the soft 
parts, and the broken pieces preserve their proper level ; and if 
there be no accompanying injury to the parts within the cranium, 
it is not necessary to do more than guard against the occurrence 
of inflammation ; but the force which breaks the bone may cause 
separation of the dura mater, laceration of the brain, extravasa- 
tion of blood within or upon it, or above and below the dura 
mater ; or a mere crack in the outer table, with fracture and 
depression of the inner table. There may be immediate con- 
cussion of the brain ; or inflammation of it and its membranes, 
may subsequently appear to a dangerous or even fatal extent. 

2. Simple Fracture, with Dep'ession. — In this form there will 
be an inequality of the surface of the skuU, varying in extent 
according to the size of the depression, and generally associated 
with a bruise of the skin. Sometimes the fragments are un- 
yielding, and sometimes they are moveable. A condition of the 
skin of the head is occasionally seen, which is apt to lead 
one to suppose that the depression is much greater than it 
is in reality, or to think that the bone is broken, when no 
fracture exists. This is a sweUing caused by extravasation, 
and it occurs in this manner: — A blow is inflicted by a flat 
instrument ; this blow is sufficient to deaden and paralyze the 
vessels of the part itself, which remains firmly compressed; 
but into the surrounding areolar tissue blood becomes extra- 
vasated, raising the soft parts to a considerable extent. This 
swelling is remarkably firm, and this condition should always be 
kept in mind, or the practitioner may think there is a fracture 
where none exists, or that the depression of fracture is much 
greater than it is in reality. 

Fracture with depression will be attended by other symptoms 
than the local ones above described, namely, by compression of 
the brain; and when a depressed piece of bone occasions the 
compression, the symptoms present themselves on the occurrence 
of the injury ; but compression may arise from other results of 
an injury to the head than fracture. For example, an animal 
has received a blow on the head which may stun him ; he re- 



lOG PARTICULAR FRACTURES. 

covers from the first shock, and symptoms of compression 
afterwards appear, and gradually increase ; there are then just 
grounds for supposing that they arise from extravasation of 
Wood within the cranial cavity. 

When the compression arises from the formation of pus, the 
symptoms do not present themselves for several days after the 
accident, and are preceded by those of inflammation of the brain 
or its meninges. The history of the case will here be most use- 
ful in guiding the practitioner to arrive at a proper conclusion as 
to the cause of the compression. 

There is no certain correspondence between the symptoms of 
compression and the extent to which a portion of bone may be 
depressed. In some cases, where depression has been slight, the 
symptoms have been very marked ; whilst in others, the symp- 
toms have been slight and the depression considerable. It is 
also a remarkable fact that injury to one table of the bone 
scarcely ever corresponds to that of the other ; the inner being 
nearly always fractured to a greater extent than the outer, and 
its actual depression much greater than would appear from 
examination of the parts external to the fracture. 

The treatment must be pursued in accordance with the symp- 
toms. In the absence of compression, the indication is to prevent 
inflammation ; and for that purpose purgatives must be given, 
and low diet with rest and quietude enjoined. It is also 
necessary to keep the head cool by means of cold wet cloths, and 
after the period of collapse — which immediately succeeds the 
injury — has passed off, abstraction of blood may be advisable. 
The administration of sedative medicines had better be withheld, 
as they may produce an impression upon the brain, predisposing 
to inflammatory action. 

If compression be present, the practitioner must, without 
delay, attempt to relieve the brain from pressure. If the bone 
be not depressed to any great extent, and the symptoms not 
urgent, bleeding, purging, and the application of cold to the 
head may be sufiicient; for it is sometimes found that the 
brain becomes accommodated to its new condition, and that the 
symptoms disappear; but if these means should not succeed, 
the depressed bone must be elevated. When the symptoms of 
compression are strongly marked, and the bone depressed to 
such an extent as to leave no hope from other treatment, the 



FKACTUEES OF THE CRANIAL BONES. 107 

fracture must be exposed by a crucial incision, and the bone 
raised by an elevator. Sometimes it is possible to introduce the 
elevator under the edge of the fractured bone ■without using the 
trephine; in the majority of cases, however, it wiU be found 
necessary to remove a part of the bone that is not depressed, so 
as to admit of the introduction of an elevator, by which the 
depressed part may be raised to a level with the surrounding 
parts of the skuU. 

The best form of trephine is the one with a moveable centre- 
bit. The elevator or lever is a very simple instrument, and can 
be made by the nearest blacksmith, being merely a chisel with a 
slight curve or elbow. Should the fracture of the inner table be 
comminuted, all loose portions must be carefully picked out 
with the forceps. 

Whilst recommending the above treatment, I am hound to 
admit tliat the force sufficient to cause fracture of the bones of 
the skulls of our patients is generally sufficient of itself to pro- 
duce instant and fatal concussion of the brain ; but, on the other 
hand, it will be found, during a long period of practice, that 
cases as described occur, especially in a city like Edinburgh, 
where the streets are hilly, paved with granite, and the horses 
shod with calkins and toe-pieces, which seem to take from the 
poor animals the power of faUing naturally when they make a 
slip, and to cause them to tumble head foremost. Prom these 
causes, fractures of aU. kinds are of frequent occurrence. 

3. Punctured Fracture. — This is caused by a sharp body, as a 
pitchfork, or by the animal falling on a pointed instrument of 
any kind ; a mere puncture or cavity being the outward visible 
effect, but the internal table, from its brittleness, is injured to a 
greater extent than the outer. This fracture is sometimes called 
" star-like " or radiated fracture, from the fact that there are 
numerous fissures or cracks in the bone, radiating from the 
centre of the fracture. 

This is a very dangerous form of fracture, requiring immediate 
trephining, although symptoms of compression may be absent. 
The danger arises from the fact that spiculse of the inner table 
are always driven inwards, and if these be not removed, it is cer- 
tain that inflammation wiU ensue. If the operation be delayed 
till then, the animal wiU most assuredly die. 

After the depressed fragments have been removed (and it maj 



108 PAETICULAE FEACTUEES. 

be possible to do this without trephining or removing any sound 
portion), the wound must be closed, and the most strict anti- 
phlogistic treatment pursued, both to prevent inflammation and 
to subdue it in case of its occurrence. 

4. Compound or Open Fracture with Depression, is the most 
common form met with in our patients ; a force strong enough 
to break the bones being sufficient to drive in the soft parts also. 

There is a wide difference of opinion amongst surgical writers 
as to the necessity of immediately elevating the depressed 
bone in this form of fracture, — Sir Astley Cooper, Sir B. Brodie, 
and others laying it down as a law that trephining must be 
performed as soon as possible, it being useless to do so when 
inilammation is once established. On the other hand. Professor 
Samuel Cooper, Sir Philip Crampton, Dease, and Desault main- 
tain that in fractures of the skull with depression, whether it be 
compound or not, no attempt should be made to elevate the 
depressed bone, unless very decided symptoms be present of 
compression or irritation of the brain ; and that they have seen 
many cases terminate favourably without the use of the trephine. 

I think that in all such cases, whether there be symptoms of 
compression or not, the veterinary surgeon should not hesitate 
to elevate the depressed bone at once ; by not doing so, he runs 
the risk of losing his patient by the inflammatory process setting 
in, when all chance will be gone. This is imperative where the 
depression is exposed in consequence of a wound in the soft 
parts, whether there be any signs of mischief to the brain or 
not ; but if there be depression without wound, and no signs of 
compression, let him make no such wound by operation. 

In ponies that work in coal-pits this is a very frequent form of 
fracture, arising from the tunnels being made so low that the 
animals are continually striking their heads against the roof. The 
force of the blows is here merely strong enough to break the skin 
and the surface of the bony crest. It is my opinion that in some 
cases the detached pieces of bone result from the continual blows 
producing necrosis. It is lamentable to think that these poor ani- 
mals are worked from week to week, and month to month, without 
an effort being made to prevent or cure such injuries. I have 
seen the skin of the forelock detached for several inches — easily 
raised up as a flap — swollen, inflamed, with an ugly, unhealthy 
wound underneath it, containing several pieces of necrosed bone, 



FEACTURES OF THE CEANIAL BONES. 109 

causing the poor brute to be nearly mad with pain, and danger- 
ous when any one approached its head. In all such cases the 
proper treatment is to remove all loose fragments of bone, scrape 
the surface of the crest, if in a necrosed condition, dress with the 
dilute acid already recommended, and bring the flap into its 
proper position, retaining it there by folds of wet cloth properly 
adjusted upon the ears and poU. Sutures or plasters should not 
be used, as they prevent the escape of any pus that may form. 

A form of bridle now in use at the pits belonging to the 
Bowling Iron Company, near Bradford, is the best and most 
effectual preventive that I have seen. It consists of a plain 
bridle, having a piece of strong harness leather extending over, 
and covering the forehead and poll, from about two inches 
above the eyes to a distance of two or three inches behind the 
ears, pierced with holes for the ears, and properly adjusted to 
the peculiarity of each head. After the adoption of this simple 
contrivance, broken heads did not again occur. It must be 
kept pliable by frequent oQing, or it is apt to become hardened, 
and to cause irritation at the base of the ears. 



CONCUSSION OF THE BKAIN. 

This is produced by a blow, or a fall upon the skuU itself, or 
a fall upon the nose, by which a sudden shock is communicated 
to the brain through the medium of the facial bones. In this 
way cases have been recorded of fracture of the ethmoid bone. 
Its symptoms are arranged in three stages — 1st. Collapse ; 
2d. Eeaction ; 3d. Inflammation of the brain. 

First Stage, or Collapse. — In many instances, the functions of 
the brain and organs of sense are suspended, so that conscious- 
ness is entirely lost, with complete insensibility to external 
impressions ; common sensation and voluntary motion are also 
lost for the time ; this loss is often so great that the animal 
gives no indication of pain when pricked with a pin or other 
sharp instrument ; lies motionless upon the gxound, or makes 
a few faint struggles with the limbs ; but is altogether with- 
out the ability of combining the action of the muscles, so as 
to perform any particular movement. The extremities, and 
surface of the body generally, are cold, the respiratory move- 
ments feeble, but not usually stertorous; the pulse is weak, 



110 PAETICULAE FEACTUEES. 

fluttering, and perhaps intermittent ; the pupils are dilated if 
the concussion be very severe, but they will usually contract on 
the application of a light, showing that the retina is not per- 
fectly insensible. If the concussion be slight, the pupils will 
be found contracted, or possibly one pupil may be contracted 
and the other dilated. These symptoms may change into the 
second stage, or into those of compression, or they may ter- 
minate fatally without any other change. 

Second Stage. — The insensibility is diminished, sensation and 
volition are partly restored, but ordinary impressions produce 
little effect, and the animal lies in a kind of sleep, although it 
is possible to rouse him for a moment by speaking loudly 
or harshly ; pricking by a pin causes him to show feeble 
signs of pain ; there are occasional signs of restlessness ; the 
pulse and circulation are more vigorous ; the skin and the 
extremities become warm by degrees ; and the animal will now 
and then make efforts to rise, which always produces an 
accelerated condition of the pulse, with loud beating of the 
heart. These sjTnptoms may subside, or may pass on to the 
third stage, namely, that of pure inflammation of the brain, with 
throbbing of the carotids and vessels of the head, injected con- 
junctivae, suffusion of tears, intolerance of light and sound, 
watchfulness, restlessness and delirium, with strong quick pulse, 
heat and dryness of the skin, diminution of the secretions, and 
other symptoms of irritative fever. These symptoms may yield 
to treatment, which must be prompt to be effectual, or they 
may pass on to those of compression, and prove fatal. 



DIFFERENT WAYS IN WHICH CONCUSSION PROVES FATAL. 

By careful experiments, the whole of the brain and spinal 
cord have been removed, and so long as artificial respiration 
was kept up, the action of the heart continued for some hours. 
From these experiments it has been concluded that the action 
of the heart is independent of the brain and spinal cord. But 
it has also been discovered that when any sudden injury, such 
as a violent concussion, is produced on a part of the brain or 
spinal cord, an immediate and great depression, or complete 
suspension, of the action of the heart is the result. From this 
it is concluded that a sudden injury of the nervous centres. 



CONCUSSION. Ill 

such as violent and sudden concussion, suspends the action of 
the heart, and thus proves fatal by syncope or death beginning 
at the heart. The vital powers of the heart seem to be destroyed, 
for when the chest is opened immediately after death, it is 
impossible to excite contraction of that organ. 

The difference between the effects of concussion and a wound 
of the brain is very remarkable. Mayo observes on this sub- 
ject — "A great part of the brain of an animal may be gendy 
and quietly sliced away with little or no effect ; but if ever so 
small a portion be suddenly crushed, the heart stops directly." 

Again, from the experiments of Chossart and others, there 
appears some variety of opinion as to the part of the circula- 
tion chiefly affected by certain injuries of the nervous centres. 
In certain injuries of the brain and spinal cord, Chossart found 
that the capillary circulation appeared for a time to be more 
affected than the heart's action ; but still it is by failure of the 
circulation that such injuries ultimately prove fatal. It is only 
by such knowledge as this that the practitioner can be guided 
to rational and scientific treatment. A peculiar fact may be 
introduced here, as exemplifying a lesion which occurs very 
frequently after the operation of pithing (dividing the spinal 
cord between the occiput and atlas, or atlas and dentata), 
namely, rupture of the vena azygos. 

In some cases, when death occurs from concussion, the heart 
is found quite empty, a condition that is not easily accounted 
for. In other cases it is distended; but the distinguishing 
peculiarity is, that there is no difference in the quantity of blood 
in its right and left sides. 

" We may sum up by stating " (says Pirrie) " that when con- 
cussion proves fatal in the first stage, it is by failure of the 
action of the heart, which is sometimes instantaneous, some- 
times gradually increasing to a fatal termination; and some- 
times there is a very partial reaction, and then a second failure 
of the organs of circulation, which proves fatal." — (Pikeie, 
Frinciples and Practice of Surgery.) 

Bearing these facts in remembrance, the practitioner will 
watch the state of the organs of circulation with care and 
anxiety. Another way in which concussion proves fatal is by 
compression, arising from extravasation of blood, serous effusion, 
or the formation of pus. 



112 PAETICULAE FEACTUKES. 



POST MORTEM APPEARANCES. 

These will vary according to the length of time intervening 
between the injury and the de^th of the patient. In cases that 
are almost instantaneously fatal, laceration of the brain is often 
observed. In other cases the dura mater is separated from the 
inner plate ; and this is a very common condition. Again, the 
venous sinuses are found lacerated ; and, in other cases, the con- 
cussion proves fatal without any lesion being visible either in 
the brain or its membranes. 

In the cases where death occurs at a more advanced stage, 
traces of inflammation will be present, such as increased vascu- 
larity of the membranes, small specks of blood in the brain, 
various kinds of inflammatory products, lymph, serum, pus, or a 
combination of these conditions. 

It has been supposed, where no lesion is apparent, that the 
sudden shock disturbing the circulation of the brain is the cause 
of death; and, again, that the structures are injured, and the 
injury not discoverable by dissection. Others think that the 
fatal result arises from condensation of the brain. One writer, 
Mr. Liston, says — " When a blow is inflicted on the skull, only 
a slight commotion of the brain is induced ; the cranial contents 
are, as it were, slightly jumbled, and a temporary and trifling 
disturbance of its functions follows. "When, however, the 
stroke is more severe, the brain is separated from its cranial 
attachments, both at the point struck and at the part directly 
opposite. It is thrown upon itself towards its centre ; its sub- 
stance is thereby condensed, its diameter in the direction of the 
impulse diminished, and a separation between the brain and the 
cranium is formed at each extremity of that diameter." 

By post mortem examinations it has been ascertained that 
condensation of the substance of the brain does exist in cases of 
severe concussion. Such condensation may be sufficient to 
cause instantaneous extinction of life; or the brain may 
gradually resume its former condition, or only with such incited 
action as may be required to reunite the dura mater with the 
inner table of the skull. 

Treatment. — In the first stage, when the symptoms of depres- 
sion are very great, and there is danger of death from failure 
of the heart's action, stimulants, as ammonia, should be ad- 



CONCUSSION. 113 

ministered, care being first taken to ascertain wlietlier tlie power 
of deglutition be present or not. If tlie power of swallowing 
be lost, medicine can stiU be conveniently given in the form; of 
a ball, which should be well oiled, and pushed as far as possible 
into the pharynx. From the great danger of reaction being 
excessive, and the tendency of inflammation to succeed, the 
administration of alcoholic stimulants will be improper, and 
means must be employed to restore the circulations that do not 
tend to have a permanent effect. The animal is to be covered 
with warm clothing, and even heated blankets can be applied 
to the extremities and surface of the body with great advantage. 
It is thought by some of the most eminent of surgeons that 
very little beyond this should be done in the first stage, as 
the period of depression tends to diminish the danger of haemorr- 
hage in case the brain should be wounded; and that if the 
circulation be artificially excited, there is much danger of com- 
pression from extravasation of blood. But whilst the indis- 
criminate administration of stimulants is thus condemned, the 
abstraction of blood would be also highly improper, and most 
injudicious, as the vital depression already existing would be 
increased to such an extent as to destroy any chance that 
might remain of saving the patient's life. In the majority of 
cases, however, it would be useless to attempt bleeding, as the 
blood would not flow until reaction had commenced, and then 
the loss of the vital fluid would probably kill the patient. 

In, the second stage, or return of sensibility, the warm cloth- 
ing, &c. should be removed, the patient placed in a cool, dark; 
and quiet loose box, cold applied to the head, a full dose of pur- 
gative medicine given, and the diet to be of the simplest kind, 
such as bran water. If there be a desire on the part of the animal 
to eat his straw, he should be bedded with sawdust, strict watch 
being kept upon him ; and if symptoms of excitement be observed; 
it may be advisable to. bleed, if the state of the pulse warrants 
such a proceeding ; but if the practitioner thinks bleeding unad- 
visable, the heart's action may be moderated by aconite, the 
most valuable of all sedatives in veterinary practice. It is given 
in small doses, from seven to ten drops of Fleming's tincture, as 
a larger dose is apt to produce some amoimt of preliminary ex- 
citement. Before administering even this most simple of seda- 
tives, the practitioner must well consider his case ; for sedative 



114 PAETICULAE FEACTUEES. 

remedies may produce an impression on the nervous system pre- 
disposing it to inflammatory action. 

In the third stage, or that of inflammation of the brain, there 
must be a prompt abstraction of blood, the administration of a 
full cathartic, and, when the delirium of the animal will allow 
the attendant to handle him, cold must be applied to the head 
by means of cold water, or even ice. 

It is necessaiy that the abstraction of blood should not be 
carried too far, for if there be laceration of the brain, the consti- 
tution may be so weakened by such bleeding as to prevent the 
process of repair being set up in the lesion. 

The signs of the inflammatory condition may subside, or may 
be succeeded by others, denoting that compression of the brain 
by blood, serum, or pus, is present ; and in well-marked cases 
there is insensibility and unconsciousness, as in the first stage ; 
— with this difference, that in mere concussion the symptoms 
pass off, and even during its contiuuance there are occasional fits 
of restlessness ; but during compression they are constant whUst 
the cause is in operation. The retina is perfectly insensible, the 
iris motionless, the pupil dilated, the respiration slow, difficult, 
and stertorous ; the animal may breathe through the mouth, the 
tongue hanging out ; and the air puffs out the checks. A cow 
in the comatose stage of milk fever will present a familiar 
example of this. Stertorous breathing arises from the relaxation 
of the velum palati, and of the laryngeal and pharyngeal muscles. 
This relaxation prevents the free passage of the air, and gives 
rise to the noise in breathing called stertor. 

This condition of the animal is that of complete coma, and 
death is caused by asphyxia resulting from paralysis of the 
muscles of respiration; and from the insensibility destroying 
the feeling of the want of air, which in ordinary circumstances 
excites the respiratory movements. 

The pulse is generally slow, full, and labouring, as the action 
of the heart does not seem, as in concussion, to be affected 
directly, but to become impeded, from the obstruction of the cir- 
culation through the pulmonary vessels. 

There is loss of the power of swallowing, from paralysis of the 
muscles of deglutition ; the action of the bowels is arrested, from 
their walls being affected by the general paralysis ; the sphincter 
ani is relaxed, and fseces are passed involuntarily ; the bladder is 



CONCUSSION. 115 

paralyzed, and cannot expel the urine, -whicli sometimes dribbles 
off in small quantities. This indicates a state of great disten- 
sion of the bladder, and that the urine forces its neck to such an 
extent as to aUow the overflow of its contents. 

Some cases are characterised by convulsive twitchings, rapid, 
feeble pulse, and hurried respiration — symptoms believed to 
denote wound of the brain rather than concussion. 

It has been discovered by dissections that lisemorrhage from 
concussion may occur in any of the five following situations : — 
Isf. Between the cranium and dura mater ; 2d. Under the dura 
mater into the cavity of the tunica arachnoidea ; Sd. Between the 
tunica arachnoidea and pia mater ; 4:th. Between the pia mater 
and brain ; and 5th. Into the substance of the brain itself. 

The method of trephining for injuries of the cranium is de- 
scribed as follows by the great surgeon Syme : — " If the bone 
be not sufficiently exposed by the original injury, a crucial or 
triangular incision must be made through the scalp, the flaps 
of which are to be dissected back. The pericranium is next 
scraped off sufficiently to prevent it from impeding the teeth of 
the saw, which is applied at first with its centre pin, to keep it 
steady, and afterwards, when a groove has been formed, this 
obstacle to its progress is removed. The sawing must be con- 
ducted cautiously, as the skull is not always equally thick, 
and is often throughout very thin, with hardly any perceptible 
diploe. A toothpick or probe should be introduced from time 
to time, to ascertain whether or not the bone be perforated at 
any part of the circle, and when the whole seems to be nearly 
cut through, an elevator or forceps may be employed to raise the 
detached piece. If circumstances appear to require the removal 
of more bone, the same means are to be repeated, or the process 
may be accelerated, if the portion be extensive, by Hey's saw, 
as it is usually called, which proves convenient for connecting 
the circular apertures together, so as to separate at once a 
large portion of cranium. After the operation the wound is 
to be lightly dressed, and the general treatment conducted with 
the view of checking any tendency to inflammatory action." 

After the operation, weU-regulated pressure should be applied 
to the part by means of pads of tow and bandages ; if this is 
not done, a tumour is apt to make its appearance, which consists 
of a protrusion of the brain, and is termed — 



116 PAETICDLAK FKACTUEES. 



HERNIA CEEEBEI, OR FUNGUS OF THE BRAIN. 

This is very similar in appearance to a mushroom, the ex- 
panded portion overhanging the skull, while the narrow part 
projects through the opening in the bone, and is connected with 
the brain. It is elastic and compressible, destitute of sensi- 
bility, of very rapid growth, and when cut into, is found to 
consist of cerebral matter and clots of blood. 

Treatment. — ^All that can be done is to cut the tumour clean 
off, and apply pressure by wet pads, and prevent all excitement. 
The tumour has a great tendency to grow afresh, and, a? a 
rule, a fatal termination may be looked for. 



CHAPTEE VI. 

PARTICULAR FRACTURES — Continued. 

FRACTURES OF THE VERTEBRA — ON BROKEN BACK — FRACTURE OF 

THE SACRAL AND COCCYGEAL BONES FRACTURE OF THE PELVIC 

BONES FRACTURE OF THE FEMUR FRACTURE OF TIBIA 

FRACTURE OF THE TARSAL AND METATARSAL BONES. 

FEAOTUEES OF THE VEETEBEiE. 

A FEACTUEED Vertebra, above the origin of the phrenic nerve, 
with displacement of the fragments, produces death, and is not 
discovered until a post mortem examination be made. This 
nerve is formed by the union of branches from the fourth, fifth, 
and sixth cervical nerves, and conveys motor power to the 
diaphragm. When this power is cut off, death results from 
paralysis of this great respiratory muscle. It is very true, as 
can be seen after an animal is " pithed," that respiration goes 
on for a short time, but it is performed with great difficulty, 
and seemingly without the aid of the diaphragm, and becomes 
slower and slower, imtil it finally ceases altogether. 

The transverse processes of the cervical vertebrae are some- 
times fractured, and by pressing upon the cervical nerve in the 
immediate neighbourhood, cause more or less paralysis of the 
cervical muscles supplied by that nerve, producing what is com- 
monly termed vn-y neck — that is, a twisted neck, the head being 
tm-ned from the seat of the injury. I had once under my care 
a case of this kind, where the fractured bone had become carious, 
communicating with the surface by means of fistulous openings. 
The horse had fallen, months before he was seen by me ; the neck 
had been persistently bent from the beginniag, and attempts 
had been made to straighten it, but without success ; the soft 
parts commenced to swell, and eventually abscesses formed suc- 
cessively, and were discharging the offensive pus peculiar to dis- 
eased bone. The use of the probe did not enable me to form 



118 PAETICtlLAS FKACTUEES. 

any definite conclusion ; but feeling sure there was detached 
hone, the wounds were opened up, a piece of fractured bone in 
a necrosed condition removed, and the wound brought together 
by suture. The process of healing was rapid, and no more ab- 
scesses formed, but the neck never became quite straight. There 
was certainly a great improvement, and the animal worked for 
years afterwards. The spinous processes of the dorsal vertebrae 
are the seat of fracture, and when this occurs, the detached 
fragments cause what is known as " fistulous withers ;" the 
sinuses must be explored, and the fragments removed. Occa- 
sionally it is found that the tuberous ends of the spines are 
merely bruised, and are in a state of caries or necrosis from the 
violence. The treatment proper for this kind of injury is the 
careful scraping away of the diseased surface. 

ON BEOKEN BACK. 

Fracture of the spine is of two kinds : — 

1. Fracture without displacement. 

2. Fracture with displacement. 

Both of these fractures may be exactly similar in situation and 
extent, and they may involve either the body of a vertebra, or 
its arch, or both. 

1st. Fracture without displacement generally occurs in the 
dorsal vertebra. In our dissecting room it is revealed that 
broken backs are no uncommon occurrences, and that the frac- 
tures have united without the animal having apparently shown 
any symptoms during life ; the bones having been kept in the 
proper position by their Ligamentous connections, and the spinal 
cord never having been interfered with. 

In practice, however, cases are sometimes seen where, after a 
severe fall, there is partial paralysis, showing clearly that the 
medulla spinalis is more or less involved in the injury ; and as 
illustrations of this, and indicative of the proper treatment of 
such injuries, I will briefly relate two cases that occurred in my 
practice while resident in Bradford. 

The first case, a truck horse belonging to the Lancashire and 
Yorkshire Eailway Company, was knocked down with great 
force by a passing truck. The force was so great as to cause the 
horse to roll over two or three times on the ground ; he got up 



BEOKEN BACK. 119 

•with difficulty, and was, when examined a very short time after- 
wards, found to present symptoms of paralysis of both posterior 
extremities. There was knuckling over at the fetlocks when 
standing, difficulty in moving the legs forward, the peculiar 
plaiting or crossing of the legs which is observable in partial 
paralysis, and the rolling, uncertain gait. Nothing could be 
found upon examination. 

The treatment consisted of quietude, rest, dose of physic, and 
fomentations to the loins. In about six weeks the paralytic 
symptoms diminished, and in about ten weeks the horse was at 
work again, and continued to work as a truck horse for four 
years afterwards, when, in consequence of a lameness in one of 
his feet, he was turned out to grass. Upon being let loose in 
the field, he commenced galloping, and going down a hill, his 
hind feet slipped from under him ; he fell heavily, was unable to 
rise, and had to be destroyed. 

The jpost mortem examination revealed the seat of the old 
fracture, the third lumbar vertebra; the process of anchylosis 
having extended to the rest of the lumbar vertebrte, the whole 
being united as one bone ; and there was a recent fracture of the 
fourth, with displacement and pressure on the cord. 

The second case was a high-spirited saddle horse, which was 
suddenly thrown upon his haunches by a strong check being 
given him by his rider, who was using a dreadfully severe bit. 
After he was thrown on his haunches, he recovered with some 
difficulty, and walked, partially paralyzed, a distance of seven 
nules into Bradford, wlaen he was seen presenting symptoms 
similar to case No. 1. The same treatment was adopted ; but 
unfortunately the owner listened to the voice of a farrier in the 
town, who asked to be allowed to put the horse in slings. When 
the poor animal felt the support of the slings, he lay, as horses 
will do while on the slings, with the legs in a semi-flexed posi- 
tion, and his weight thrown upon the trunk. As a natural result, 
the back arched upwards, and immediately there was displace- 
ment of the fractured vertebra, and total paralysis of both hind 
limbs. When seen again by me, he was greatly excited and 
very restless, and was ordered out of the slings. When the slings 
were removed, the hind limbs were quite unable to support; 
him ; he therefore went down, and, being a high-mettled horse, 
commenced to fight and struggle with the fore legs, to knock his 



12,0 PAETlCUliAE IRACTUEES. 

head against tlie wal, manger, &c., bruising liimseif in a fearfd 
manner. Seeing that he was in great agony, and the chance of 
recovery now hopeless, he was destroyed. The post mortem 
examination revealed' fracture through the body of the last dorsal 
vertebra.' I am satisfied that this case would have eventually 
recovered if he had not been interfered with, as there was no 
fever ; the appetite was good, and the animal cheerful before the 
slings were used. 

' Fractures of the spine occur during the performance of a 
Surgical operation when the animal is cast. 

Let it be here clearly understood that such fractures rarely if 
ever occur during the fall, but when the horse is down on the 
ground, and struggling from the pain of the operation, or from 
the inconvenience of his position. Broken backs during the 
performance of operations are much more common in Scotland 
than in England; this arises from the different methods in 
which horses are bast. The late Professor Dick used to say :— 
" Fracture of the body of the bone (a vertebra), while the horse 
is under operation, sometimes takes place; this is to be pre- 
vented by placing a back rope on the horse before he is cast, 
and then it is to' be tied round the legs and back, to prevent the 
animal struggling while down." '■ 

Now, with all due deference to the teaching of the late Pro- 
fessor, I must here say that the immense number of broken 
backs which we hear of in Scotland arises from the circumstance 
that the animal is fastened so that he cannot struggle ; whereas 
he should be allowed more or less freedom of motion while he is 
confined in the hobbles. 

By using the " lack rope," as recommended by Professor Dick, 
the great muscles of the loins, quarters, and thighs are made to 
act upon two fixed points, namely, the spinal column on the one 
hand, and the extremities on the other; and when muscular 
force is exerted to such an extent as we see when an animal is 
down, one of the points is likely to give way ; whereas, if the 
extremities are allowed a little freedom, the force is expended in 
moving them, and there will be but little or no danger of a 
broken back. 

If it were possible, by so fixing the animal, to destroy mus- 
cular action, it would be a great convenience to the operator ; 

1 From Notes of Professor Dick's Lectures, delivered during Session 1853-6. 



BROKEN BACK. 12l 

but tLe muscular force remains in spite of all the tying down 
that can he done with ropes, and bones will as surely be 
broken. 

I have always held the opinion now laid down ; and although 
it might have been shaken during my first college days, it 
returned to me with greater force from seeing a horse break 
Ills back whUe tied down with the back rope. Wlien I first 
promulgated this idea, during my first course of lectures at the 
Edinburgh Veterinary College, the majority of the senior stu- 
dents thought my teaching absurd ; and to prove it so one of 
them purchased a subject for dissection, and before destroying 
him, had him cast for the instruction of his fellow-students, 
and secured so firmly that he could not break his back, as he 
said ; but, wonderful to relate, the animal tried to struggle, the 
back was broken, and he rose no more. 

It is a general belief among veterinarians that a horse with a 
broken back cannot move his tail ; but this is liable to excep- 
tions, and it will be found that complete paralysis from fracture 
will be accompanied at first by movements of the tail. To take 
this symptom as being diagnostic of fracture, and to conclude 
that when movement of the tail remains, the injury is a sprain 
of the psose muscles, may lead to error and wrong prognosis. 
Absence of sensibility and the history of the case are much 
more to be depended upon. 

As a rule, but not without exception, vertebrae are fractured 
through their bodies, the arches remaining intact. 

FRACTUEES OF THE OS SACRUM. 

The anterior portion of the border of this bone is sometimes 
fractured by violent falls, or by the animal becoming " cast in 
the staU." It wUl be remembered that the sides of the os 
sacrum are attached to, and situated below, the posterior spinous 
process of the ilium, giving support and attachment to the 
pelvis, and connecting it with the vertebra. When it is frac- 
tm-ed, the iliac spine, losing its support, immediately falls, and 
the highest part of the quarter becomes flattened, which can 
be easily seen by comparison with its feUow of the other side. 
Examination per rectum will enable the practitioner easily to 
diagnose the exact seat of the injury. I'rofessor Dick used to 



122 PAETICULAK FEACTUEES. 

say that in this fracture the legs bent under the horse, and that 
this was its diagnostic sign. 

Treatment. — Slinging and rest; and as a rule cases terminate 
very satisfactorily, all that remains being the flatness of the 
quarter. 

The Coccygeal Bones are also liable to fracture, which may 
be detected by inability on the part of the patient to raise the 
tail, difficulty in defaecation, and by crepitation. 

Treatment. — Strong leather binding laced around the tail, ex- 
tending from its upper to its lower part, proper padding being 
at the same time used to prevent excoriation. 

The rudimentary spines of the false vertebrae of the tail are 
sometimes fractured, giving rise to troublesome sinuses. 

The wounds to be laid open, and the detached bones removed. 

A comminuted fracture of the bones of the tail, with violent 
bruising of the soft parts, succeeded by inflammation, and even 
gangrene, is occasionally seen in practice. In such, amputation 
of the tail and removal of all the fractured bones must at once 
be resorted to, or serious consequences may result, such as 
irritative fever or tetanus. 



FEACTUKE OF THE PELVIC BONES 

May be arranged under seven heads : — 

Is^. Fracture of anterior iliac spine, 

2d. „ of posterior iliac spine. 

3d „ of the shaft of the ilium. 

4ih. „ through the acetabulum. 

bth. ,, into the foramen ovale. 

6th. „ through the symphysis pubis. 

*Ith. „ of the tuberosity of the ischium. 

Fracture of Anterior Iliac Spine. — This is the most common 
form of fracture to which the horse and the cow are liable ; it is 
generally caused by falls, or by the animal striking this part 
against a wall or side of a doorway, most commonly the latter, 
and chipping off, as it were, more or less of this prominent part 
of the quarter. It is not always attended by lameness, and is 
distinguishable by lateral flatness of that quarter. 

The broken piece of bone is drawn inwards and downwards 



FKACTUKE OF THE PELVIC BONES. 123 

by the action of the abdominal muscles attached to it. In this 
fracture we find the method of repair is by false joint, the frac- 
tured ends being connected by a fibrous or a fibro-cartUaginous 
tissue. This is due to the action of the muscles attached to the 
fragments keeping them in a state of continual motion, and is 
an example of arrested development of the reparative material ; 
every other part of the process of repair may be complete but 
that of ossification ; and the fragments are held together by a 
yielding and pliant bond. 

There is very little treatment necessary in a case of this kind. 
If the soft parts are injured, physic, fomentation, and a short 
rest -wlU be sufficient. 

Now and then, however, we meet with a case where no 
attempt at repair is made, and the broken fragment or frag- 
ments die, or become necrosed, giving rise to the formation of 
sinuses both near to and below the seat of injury. In such a 
case it will be necessary to remove the irritating fragments, 
and treat according to the rules already laid down. 

Although a horse that is flat in the quarter may not be un- , 
sound, yet he is of less value in the market than if he were all 
right. It is, therefore, of importance that the practitioner should 
compare the two quarters of every horse he examines as to 
soundness; and this should be done by standing behind the 
horse examined. 

The next four forms of fracture of the pelvis present ex- 
ternally symptoms similar to each other — namely, a flatness 
of the surface of the quarter, and lameness, with great difficulty 
in extendrag the foot, particularly if the toe strikes the ground. 

The exact seat of the fracture is to be determined by an 
examination per rectum, when movement of the limb will 
indicate this by crepitation and motion in the part. As a rule, 
if the patient be laid, he will have great difficulty in rising; if 
through the acetabulum, he will scarcely be able to rise even 
with assistance ; and when he is up, the limb is unable to bear 
any weight, and it will be shorter than its fellow, from the head 
of the femur being drawn upwards on to the dorsum of the 
ilium by the action of the gluteal muscles. The trochanter will 
be felt farther back and higher up than usual ; the toe will be 
turned inwards, and rest upon the coronet of the opposite foot. 
Fracture through the acetabulum is the only one where re- 



124 PAETICULAE FKACTUEES. 

coVery is hopeless ; aU the others being curable, provided the 
fracture is not due to previous disease of the bones, namely — 
fragilitus or molhties ossiiun. 

Fracture of the shaft, or into the foramen ovale, may occur 
without immediate displacement, and the animal show no sign 
of lameness until such displacement occurs. 

In a case which once came under my observation, it was 
found that the fracture was of several weeks' standing, although 
the horse had worked perfectly sound in a carriage up to the 
time of the displacement.^ 

The fracture arose from moUities ossium, which was present 
also in the tarsal and other bones ; and when displacement 
occurred the animal was at work upon a level road, and going 
at ordinary speed. He did not fall, but suddenly became very 
lame. 

It has been already stated that fracture through the aceta- 
bulum is hopeless, therefore no time should be lost in putting 
the animal out of pain; but in the other forms, the patient 
should be slung, and in order to do something to keep the parts 
at rest, a stiff pitch-plaster ought to be applied to the whole 
quarter. Apparent recovery wiE take place in from two to 
three months, but care shovdd be taken not to put the animal to 
work too soon. 

If the horse has to be moved any distance after the occur- 
rence of any of the curable fractures mentioned, his movements 
wiU be made very much easier by the attendants tying a cord 
round the foot of the lame limb, to assist in its extension, and 
to prevent the toe coming to the ground first ; for it will be seen 
that if the toe strike the ground first, the patient will knuckle 
over at the fetlock to a most alarming degree ; indeed, this 
knuckling over wiU sometimes be so great as to cause the 
animal to fall to the ground. Cases of this kind have repeatedly 
occurred in my experience, and by the simple expedient here 
mentioned — the attendant taking care to pull the foot forwards, 
and rather upwards before it touches the ground, so as to 
ensure its faUing flat — ^the animal has walked with compara- 
tive ease. 

^ I had diagnosed this to be a fracture of long standing before be waa destroyed, 
and arrived at this conclusion from the fact that there was much thickening and 
indolent swelling to be felt per rectum. 



FRACTURE OF THE PELVIC BONES. 125 

Fracture thrcmgh the Symphysis Pubis. — This form of frac- 
ture is caused by the posterior extremities suddenly slipping 
outwards. Its symptoms are — a wide straddling gait behind, 
the legs being dragged forwards in progression; the feet 
wide apart, the toes turned outwards; the lameness being 
sometimes excessive. Examination per rectum will enable 
the practitioner to determine the extent and exact nature of 
the lesion. 

Very little can be done in the way of active treatment. If 
the animal is not of much value, he had better be destroyed ; 
but if young, or worth the cost of keep and treatment, he may 
be slung, the limbs pulled as near to each other as possible, and 
kept in that position by being fastened with a strap above 
the hocks. In two or three months a fair recovery may be 
expected. 

Fractures of Tviberosity of Ischium arise from the patient 
falling backwards upon the buttocks, either from a slip 
whilst backing, or by being pulled over M-hilst rearing. The 
symptom is flatness of the most rounded part of the quar- 
ter, observed when standing to one side of the patient. An 
alteration in the form and shape of the quarters from any of 
the other kinds of fracture is observable when the practitioner 
stands at a short distance behind the patient ; but this is to be 
seen to perfection when he stands at a short distance on one 
side, and on a level with this part of the body. Manipulation 
will detect crepitus, and cause pain. In some cases there wiE 
be considerable swelling of the soft parts, which will partly hide 
the flatness of the buttock. There is some degree of lameness 
in these cases ; but if rest be enjoined, repair of the fracture wUl 
soon take place. Wo special surgical treatment wUl be needed, 
beyond the application of a good stiff charge or plaster after the 
subsidence of the swelliug. 



FRACTURES OF THE FEMUR. 

The femur may be fractured through its neck or through its 
shaft, and both forms are incurable. Fracture through the neck 
commonly occurs along with fracture through the acetabulum, 
and is to be detected in the same manner. Both in this form, 
and when occurring through the shaft, there will be shortening of 



126 



PAETIC0LAE FEACTUEES. 



the limb, the toe being turned inwards, except when the head 
of the femur is forced into the foramen ovale, when the limb 
will be found longer than its fellow, and the toe will be turned 

outwards. Fracture of the femur 
sometimes residts from muscular 
contraction, when the animal is 
cast and bound for operation, dis- 
placement generally being the 
immediate result; and from the 
numerous muscles which clothe 
and are attached to this bone, re- 
duction of the fracture is an im- 
possibility. 

Fracture of the Trochanters. — 
I have seen two cases of fracture 
of trochanter minor externus, from 
the patient having fallen whilst 
in the cart, this part of the thigh 
coming in contact with the shafts. 
Any one who has seen a horse 
down, and half turned round in 
the shafts, will easily understand 
this. The diagnosis is difficult, 
and the lameness is peculiar. 

Fia. 12.-Fracture of Beck of The elevation - of the foot from 
femur, showing displanement of the ground, and the commence- 
StioTotteC^ryT^t^t Bxent of the act of extension of 

head ; 6, troohanter major ; c and the limb, Seem to be performed 
d, surrounding deposit. ^.^^ ^^^^ ^^^^^ difficulty; but the 

concluding part of the elevation of the limb, and extension of 
the femur on the pelvis, give the patient much pain, and cause 
considerable lameness. The foot is let down with a jerk; but 
after descending a short distance, the pain seems to abate, and 
the final implanting on the ground is performed with compara- 
tive ease and freedom. "When the foot is implanted on the 
ground, another peculiarity may be observed, namely, that the 
extension of the pelvis on the femur is performed with difficulty. 
In order to see all these peculiarities, the practitioner must be a 
close observer. But to assist the young practitioner, let him 
remember — 1st. The first act of raising the foot is done easily ; 




FKACTURES OF THE FEMUE. 127 

2d. The latter part of this, and the abduction of the thigh, cause 
pain and lameness ; Sd. The pain caused by the last act produces 
a jerk when the limb is suddenly dropped, but when it has de- 
scended a very short way the pain is relieved ; 4:th. When the 
foot is on the ground, and before the first act of elevation, the 
trunk is carried forward in the act of progression in a painful 
and peculiar manner. These peculiarities are explained by the 
fact that the gluteus-externus is attached to this trochanter, and 
that this muscle is an abductor of the thigh and extensor of the 
pelvis. 

The treatment is rest, and slinging, if the lameness is great, 
or sufficient to prevent the animal from lying down ; with sooth- 
ing applications to the part. 

Fractures of the condyles sometimes occur. One case hap- 
pened in the practice of a friend of mine during operation. 
The animal was immediately killed, and an examination made, 
when it was found that the fracture was of some duration, and it 
came out afterwards that the animal had been cast in the stall 
some few weeks previously ; that he had shown a little stiffness 
for a day or two, but that this had passed off. The bone is in 
my possession. 

The patella is fractured longitudinally, or into several frag- 
ments, by direct violence ; and transversely, by muscular con- 
traction, causing great lameness, more or less inability to extend 
the limb, swelling in. front of stifle joint ; these symptoms being 
common to both kinds, with distinct separation of the two por- 
tions when the fracture is transverse. Eeunion of this form 
is an impossibility, owing to the difficulty of bringing the frag- 
ments together, and from the presence of the synovia in in- 
creased quantity ; on the other hand, a longitudinal fracture is 
sometimes curable, especially if it be a mere crack in the bone. 
In order to secure as much repose as possible, the part must be 
thrown into a state of relaxation, and for this purpose a shoe 
with a high toe-piece, and heels must be put on the foot, a veri- 
table " patten shoe," the animal placed in slings, and cooling 
applications employed to reduce inflammation and swelling. 
After a time a blister may be applied, as a considerable effusion 
is apt to take place into the bursa, the absorption of which is 
Qecessary before reunion can take place. 



123 PAETICULAU FKACTTIRES. 



FEACTURE OF THE TIBIA. 
Perhaps this is the most common form of fracture met with 
in the extremities, arising from kicks, and occurring most 
frequently when a number of horses are turned out to grass. 
The kick is delivered from the side opposite to the fractured 
limb, and descends upon the internal surface of the tibia, where 
it is covered entirely by skin, fascia, and strong periosteum. 
No other symptom of this fracture than a small punctured 
wound may be present, the animal exhibiting little or no lame- 
ness, although the fracture may be extensive. The fracture is 
generally very oblique, and the periosteum being strong, the 
ends are not separated. Many cases are on record where horses 
have worked at all kinds of labour for days after the receipt 
of injury without manifesting any signs of lameness, until by 
a sudden twist of the limb separation has taken place. Another 
cause of displacement is the animal's lying down ; when he 
attempts to rise, the broken ends are forced asunder, perhaps 
a sharp-pointed extremity of the broken bone driven outwards 
through the skin, rendering the case almost beyond remedial 
measures. All cases of punctured wounds of this part, from 
the violence of kicks, should be treated as if the bone were 
fractured, until the practitioner is perfectly satisfied upon the 
matter. The patient should be put in the slings, and kept 
there until the wound is perfectly healed, and the horse quite 
free from lameness. If there be no fracture, but little thicken- 
ing will be left after the subsidence of the inflammation ; but 
if there be a fracture, the veterinarian will be able to detect 
the presence of the provisional callus. Non-attention to these 
practical points has caused the destruction of many valuable 
horses. There is little danger of displacement if the patient 
be kept in the slings; but if quite sure that fractures exist, 
the tarred cord should be applied round the leg from the foot 
upwards, as high up on the thigh as possible. Some portion of 
the fragments may thus be included in the cord, for it must be 
reraembered that the cleavage, being oblique, will extend for 
some distaiice both above and below the actual wound. 

If displacement has occurred before measures can be applied, 
it will be found almost an impossibility, unless the patient be 
very young, to perform reduction ; and the best course wiU be 



FRACTUBE OF THE TIBIA. ■ 129 

to destroy the suffering animal ; but in tlie young, and in cases 
where treatment is insisted upon, the first step must be the 
removal of any projecting i bone by the bone forceps, and after- 
wards traction, applied by means of cords to the hock and leg, 
to produce extension ; in this way, and by proper manipulation; 
the fragments may be approximated and retained in their 
position by' the means already described; 



FEACTUEE OF THE TARSAL AND METATAESAL BONES. 

The Os Calcis. — Transverse fracture of this bone is caused by 
muscular contraction, and by the slipping forwai'd of the limb, thus 
throwing the gastroc-nemius externus, which is attached to the 
upper extremity, into an unduly extended condition, and the bone 
suddenly giving way in preference to the tendon of attachment, or 
the fracture' may occur spontaheoiisly when the bone is diseased. 
This fracture is mostly seen in young horses, where the apophysis 
is not completely solidified to the body of the bone. This' 
accident arises from the same causes as those which produce 
" curb ; " in the one case, however, the bone is the structure to 
give way, while in the other the calcaneo-cuboid ligament 
receives the injury. 

Inspection of the limb wiU demonstrate a flatness of the 
point of the hock, flaccidity of the teTido achilles, with an 
apparent shortening of the limb; there is no shortening in 
reality, but great difficulty in bringing the foot to the ground. 
The lameness is very considerable ; manipulation will enable the 
practitioner to discover the detached portion Of bone> resting in 
front of the os calcis, in close contact' with the flexor pedis 
ferfordns, on the postero-internal aspect of the hock. -It is 
easily moved by the hand, and can. be elevated almost into its 
natural position; 

Treatment. — Apply a high-heeled shoe, then force the frag- 
ment into its proper position, if practicable, or as nearly as 
possible, retaining it there by pads of tow and bandages. The 
tow must be made into firm pads or rolls, and pressed down in 
front, and on both sides of the fragment, to prevent it from fall- 
ing forwards. Over the dry bandage the starch bandage must 
be carefully laid, extending from the foot over the hock as 
high as possible, in order to keep the limb in a state of rigidity. 

K 



130 PAETICULAS FRACTURES. 

The patient is now to be placed in slings ; in about two months 
consolidation may be expected ; the horse may now be placed 
in a loose box or sent" to grass. I have seen very good re- 
coveries from this accident ; but if the bone be in a diseased 
condition, moUities or fragilitus ossium, treatment will be of no 
avail. 

The tarsal bones are all liable to be fractured by direct 
violence (see Photo-Uthograph, Plate II., Fig. 6— Fracture of 
the Astragalus), and, if associated with a wound, it is necessary 
to destroy the animal ; but cases of very severe injuries without 
wound occur, where the patients completely recover ; and ex- 
amination after the death of the animal, perhaps years after- 
wards, reveals the fact that the bones had been broken. It 
wiU be understood by the anatomist that this applies to the 
cuneiform and cuboid bones only ; for where the astragalus has 
been involved, only one method of repair can take place, and 
that is anchylosis of the true hock-joint. It is most difficult to 
diagnose this form of injury correctly, from the great tendency 
to immediate swelling of the part, and from the absence of 
crepitation ; the reason being that the bones are firmly bound 
to each other, and to the metatarsals, by very numerous liga- 
ments. 

If the patient be worth treatment, it will be advisable to 
apply the high-heeled shoe, to place him in the slings, and to 
abate irritation and fever by fomentations lightly appUedj by 
sedatives, or even anodynes, as aconite and opium, regulating 
the action of the bowels by laxative food and gentle aperients. 
After the subsidence of the fever and of the local heat, when 
two or three weeks have elapsed, a blister wiU be of great service 
in removing pain, and in hastening the process of ossification. 
Fractures occurring below the hock, except from kicks or blows, 
are extremely rare ; they may result from concussion, or the 
sudden twisting of the limb ; but they are much more commonly 
found to occur from these causes in the anterior extremities. 
I shall therefore consider them along with those of the fore 
limbs. 



CHAPTEE VII. 

PAETICULAE FRACTURES — Continued. 

FRACTURES OF SCAPULA — HUMERUS — CONDYLES — OLECRANON — RADIUS 

ULNA TRAPEZIUM, CARPAL, METACARPAL, AND SESAMOID BONES 

" SPLIT PASTERNS " NAVICULAR AND PEDAL BONES BROKEN 

RIBS LUXATIONS CASE OF DISLOCATION OF THIRD CERVICAL 

VERTEBRA. 

The College Museum contains many cases of recovered fractured 
scapulae ; and this bone is liable to be broken through its neck 
or body by muscular contraction, and through its spine by direct 
violence, caused by blows or falls, 

Compound fracture of the spine wiU sometimes be found to 
exist with the fragments completely detached ; in such a case, 
they must be removed. 

When the body or neck is the seat of the lesion, if there is not 
much displacement, speedy reunion wiU take place, and the ani- 
mal completely recover, provided the articulation be not involved. 
But little can be done in these cases beyond enjoining quietude, 
placing the animals in slings, and watching for untoward com- 
plications. 

Wlien the humerus is broken, I am of opinion that perfect 
soundness is impossible, although Professor Dick taught that 
such might take place. The practitioner well knows that many 
powerful muscles are attached to this bone, the action of which 
will render the retention of the broken bone in anything like its 
proper position an impossibility. Fractures of the tubercles, of 
course, like those of the trochanters of the femur, will be an 
exception to this rule. 

When the humerus is broken, there is an immediate shortening 
of the limb, from the inferior portion of the bone being drawn 
upwards by the muscles attached to it ; great lameness ; and 
there is very often a rupture of the humeral artery, or of one of its 



132 PAETICULAE FEACTUllES. 

large brandies, witli subcutaneous lisemorrhage, causing great 
engorgement of this part of the limb, and rendering the detec- 
tion of crepitus an impossibility. But the practitioner need not 
hesitate in arriving at a correct diagnosis, as the pendulous leg, 
inability to place any weight upon it, and the sudden engorge- 
ment are quite sufficient to prove the existence of the fracture. 

This fracture may arise from muscular action ; but commonly 
it is caused by falls. One case, however, has come under my 
notice, where it arose from fragility of a portion of the shaft of 
the bone, from its being contihilally brought into contact with 
the carriage pole. 

The animal was a very fine carriage horse, one of a pair, with 
splendid and fast action. Shortly before the final catastrophe 
he showed signs of a slight lameness, attributable to the shoulder ; 
with short rest and treatment he recovered, and was put to work, 
at which he continued for some little time. Whilst out one day, 
and upon a very level road, that between Bingley and Keighley, 
in Yorkshire, and going at a good pace, he suddenly fell — the 
leg coinpletely giving way — bringing the other horse, carriage 
and all, to the ground. He could not rise, the humerus was 
fractured, and, upon examination, it was found to be in a state 
of degenerative disease just at the part which was on a level 
with the carriage pole. 

■ The condyles of the humerus are occasionally fractured, and, 
as a rule, they never reunite, the reason being the impossibility of 
keeping the limb in a state of complete rest. 

The radius and ulna are fractured by direct violence, and the 
olecranon by muscular contraction. In dogs this fracture is not 
at aU uncommon ; and, if properly fixed with bandages, generally 
recover without leaving much lameness. I have noticed one 
case of dislocation of the elbow-joint, accompanied by rupture of 
the internal lateral ligament ; although treated for some time, it 
did no good, and was ultimately destroyed. The dislocation was 
easily reduced, and bound up very firmly ; but owing to diseased 
action having taken place in the joint, it was seen that anchylosis 
would be the result. In the case of a brood mare, or valuable 
stallion, cases of this kind might very justly be treated ; but in 
horses required for work it will be' better to order the patient to 
be put out of pain, as a horse with a stiff elbow is of little use. 
A dislocation is easily distinguished from fracture, as in the one 



FfiAGTUEES OF THE SCAPULA,' ETC. 13§ .^ 

case you have displacement and contortion without crepitus, 
whereas the sound is present in the other. There never need be 
any difQculty in diagnosing fracture when displacement has 
resulted ; the dif&culty is in forming a correct opinion when this 
has not taken place. 

The olecranon is fractured transversely hy over-extension ; it 
snaps across about its middle. ■ It will be remembered that the 
very powerful triceps and scapulo-ulnaris muscles are attached 
to the olecranon. When the animal slips forward to any great 
extent, these muscles are thrown into a state of great tension ; 
in fact, they are extended beyond their limit. The results froni 
this are, laceration of their tendons of insertion, fracture of the 
bone into which they are inserted, rupture of the muscles them- 
selves,- or aH these lesions combined. Any of these cause 
immediate and great lameness ; the animal will stand with the 
whole limb in an exceedingly relaxed and semi-flexed condition, 
with almost total inability to move it, and to support any weight 
upon it. The detached bone being drawn upwards into th^ 
deep bed of muscular tissue posterior to the humerus, and the 
parts, as a rule, immediately swelling, crepitation cannot be 
detected, and it becomes a matter of great difficulty to form a 
correct diagnosis. Mr. Anderson, V.S., Glasgow, has discovered 
an almost unfailing way, and it is as follows : — ^Let the practi- 
tioner place his knee firmly against the knee of the patient's 
injured leg, and by firm pressure he is to straighten the semi- 
flexed limb, and to keep it in that position, while an assistant 
is directed to lift up the horse's opposite fore foot. If the ole- 
cranon is fractured, the patient is unable to stand ; but if there 
be merely laceration, he will be able to bear his weight, with the 
assistance at the knee given by the practitioner. 

There are two positions in which the Limb is maintained when 
suffering from this injury, namely, semi-flexed with the foot in 
advance, with the heel touching the ground; or semi-flexed 
with the foot behind, knuckling over, the toe only touching the 
ground, and turned inwards. 

Correct diagnosis is of the greatest importance in cases of this 
kind, as in laceration of the tendons, or of the muscular struc- 
ture, a recovery may be expected ; whereas, if the bone is broken, 
little good can be done if the fracture is complete, and the 
fragments are separated by muscular action. 



134 PAETICULAK FRACTUKES. 

In this fracture it will be found that union is by false joint. 
This will interfere more or less with the action of the animal 
ever afterwards ; but by far the most common result is intense 
inflammation, set up by the irritation of the broken fragments, 
which become necrosed, abscesses form, commonly communi- 
cating with the elbow-joint, and the animal dying (or having to 
]>« destroyed) from irritative fever. 

Eeasoning from these facts, I am of opinion that the most 
rational method of treatment will be at once to cut down upon 
and remove the fragment or fragments which may be separated 
from the bone, bringing the lips of the wound together by suture, 
applying the slings, and other appropriate remedies. 

There is a peculiarity about injuries to the neighbourhood of 
the elbow which leads to the burrowing of any pus that may 
form into the articulation, and in this way cause a most dis- 
tressing complication — that of open joint. Kicks or punctures, 
although they may be inflicted upon a part of the fore arm, at 
a distance of four inches from the joint, will often produce this 
dreaded complication, if great care is not taken in giving free 
vent to all collections of matter ; and the reason for it is to be 
found in the peculiarly firm nature of the muscular and other 
structures of this part, the muscles being individually clothed 
in firm thecse, and the whole enveloped in the brachial fascia. 

Treatment. — Eest in the slings, and the maintenance of the 
limb in the position most calculated to favour the process of 
repair by a properly adjusted shoe — high-heeled or otherwise — 
or by the removal of the shoe, as each individual case presents 
its own peculiarity of symptoms. These details of practice must 
be left to the judgment of the practitioner, who alone wiU be 
able to carry out what may strike him as essential to the well- 
being of his patient. 

Fracture by direct violence is that most commonly met with, 
and, in the majority of instances, from falls in the cart ; the 
elbow being thrown across the shaft, and both radius and ulna 
broken through into the articulation. 

This lesion is easily diagnosed by distortion and crepitus. 
No treatment can be recommended. 

If the ulna only is broken, it will be found that the fracture is 
through "the beak of the olecranon," involving the surface, which 
articulates with the humerus between and behind the condyles. 



SPLIT PASTERNS. 135 

No treatmentj as the whole joint is sure to become involved 
in the inflammatory action. 

The radius is broken at its upper third, the ulna sometimes 
being involved ; if it be transverse, or not sufficiently oblique 
to involve the elbow-joint, it is, as a rule, amenable to treat- 
ment. I have seen many cases do very well. It is much 
easier to treat than when the ulna only has given way, for in 
the latter instance it is very difficult to bring the displaced 
fragments into proper position, as the muscles act upon it, and 
draw the fragments apart. 

But when both radius and ulna have given way, the displace- 
ment is less, and we have greater command over the limb than 
over the ulna, which is fixed to the radius by interosseous liga- 
mentous tissue. In the treatment of fractured radius, or of 
both bones combined, the reduction must be effected by ex- 
tension and counter-extension, and the fragments kept in 
apposition by bandages, tar-cord, and by the long splint. 

The radius is broken at its lower third from direct violence, 
as kicks and blows ; the nearer it is to the knee, the greater the 
difficulty in managing the treatn;ent. 

Fractures of the bones of the knee arise from direct violence, 
as kicks and falls. As a rule, there is no treatment. The 
upper and middle row of catpal bones are most commonly the 
bones broken. If from a faU, the tendon of the extensor 
metacarpi magnus is lacerated and torn, and the wound will 
be upon the front of the knee. 

One case of fracture of the trapezium has been mentioned to 
me by Mr. Anderson, Glasgow. The case was treated for a long 
time, but, I believe, with no good result. 

The metacarpal bones, as weU as the suffragines, more espe- 
cially the last-named bones, are broken into many fragments, 
sometimes into scores of pieces, most mysteriously, while the 
animal is galloped upon sandy or soft ground. The sandy beach 
of PortobeUo is noted for this. 

Transverse fractures of the sesamoids sometimes occur spon- 
taneously when the bones are in a fragile condition from organic 
disease, and are incurable. The symptoms are descent of the 
fetlock pad, elevation of the toe, with great lameness, and the 
presence of a depression, marking the seat of the fracture in 
the bone or bones. 



PARXICULAE FRACTURES. 



; Simple fractures of the pastern bones, even when the joint is 
involved, make good recoveries when properly treated by band- 
ages, splints, and rest in the slings. 

Split pastern is of common occurrence. 

The diagnostic signs of this are very sudden and severe lame- 
ness, occurring when the animal is upon a hard road ; the lesion 
arising from concussion. 

Sometimes crepitus can be detected, but very often this is 
absent, from the fact that the bone is bound most securely by un- 
yielding ligaments. The suffragines are most commonly broken, 
but it is not a rare thing to find the coronse fractured also. 




Fig. 13. — Perpendicular split 
through the central groove on the 
upper extremity of os suffraginis. 



Fie. 14. — Irregular fracture of 
upper extremity of os sufiraginis. 



When one bone only is broken, recovery is the mle, although 
the articulation may be involved. 

In the course of a day or two after the accident, the pastern 
will swell, and the swelling is of a hard, unyielding character. 
This is a favourable sign, as it indicates the formation of plastic 
lymph in the part, and the commencement of the process of repair. 

There is no necessity for very firm bandaging, especially if 
crepitus be absent. The shoe should be carefully removed, and 
the horse allowed to stand with the lame foot upon sawdust, or 
some material which will adapt itself to the form and peculiari- 
ties of the position of the foot. The toe of the foot will only 
touch the level ground, and it will be a great relief to the horse 
if the material he stands upon will allow the heel also to be 
supported. In about two or three months, depending upon the 
progress of the case, if the injury be to a fore extremity, the 
slings -may be removed ; but if it be a hind leg, the slings must 
be made use of for a longer period. 



FKACT.UEE OF THE SESAMOID BONES. 137 

I have seen one case of transverse fracture of the sesamoid 
bones, both bones being involved. The diagnosis was difficult, 
as there was much swelling around the fetlock ; the toe was 
elevated ; the fetlock pad came to the ground ; and there was 
very great lameness ; and the symptoms were exactly like those 
of rupture of the superior suspensory ligament. The horse, being 
an old one, was destroyed. I do not see that there can be a 
possibility of rendering an animal sersiceable after an accident 
of this kind. In the first place, it would be almost impossible 
to keep the fragments in contact, owing to the tendency of the 
fetlock to fall downwards and the toe to be drawn upwards by. 
the extensor pedis ; and, secondly, the sesamoids, articulating 
by one surface with the metacarpal, the fetlock joint would 
become anchylosed, and by the other surface forming a synovial 
bursa, over which the perforans glides, the tendon would be- 
come diseased to a considerable extent, constituting a permanent 
lameness. 

Fracture of the navicular bone occurs in two ways ; first, by 
direct puncture, as when a nail penetrates the frog. These cases 
are rare, but they do happen ; the symptoms are excessive lame- 
ness, presence of the foreign body, or of the wound from which 
it has been removed, synovial discharge, abundant, often bloody, 
and after a time mixed with flaky pus; abscesses pommonly 
form around the coronet ; the animal suffers from a high degree 
of irritative fever, and if not put out of his suffering, dies from 
pain and exhaustion. It is of the greatest importance to know 
if the bone be broken or not, as many cases of open navicular 
joint recover when uncomplicated with fracture. 

In open joint without fracture, the pain and fever may be as 
great at first as when fracture is present, but the discharge from 
the wound will be synovial, straw-coloured, or mixed with a small 
quantity of odourless pus ; whereas, if the bone be broken, there 
wiU be more or less continual oozing of blood from its cancel- 
lated tissue, tinging the discharge with a dirty-red hue, and 
giving it a foetid odour. "When these symptoms are present, say 
in two days after the injury, the animal had better be destroyed. 
It is as well to wait, say for two days, as the colour may be due 
to the oozing of blood from the soft structures, and not from the 
bone. 

The other way in which, the navicular bone is fractured, ia 



138 



PAETICULAE FRACTUEES. 



when it has been nearly worn through by the caries of chronic 
navicular disease. Very often this fracture is accompanied by 
rupture of the diseased portion of the tendo ^perfwaiis, and in 
such a case the toe is immediately turned up, making the diag- 
nosis certain ; when this complication is not present, it is more 
dif&cult to arrive at a sure conclusion, and the history of the 
case must be taken into account. The horse has been lame, but 
serviceable, for a long time, and aU. at once he becomes help- 
lessly lame and unfit for further use. The practitioner must 
draw his own conclusions, and reason upon the case, as no set 
rule can be laid down. 

This form of fracture occurs very often after the operation of 
neurotomy, from the increased freedom of motion which results 
upon the removal of pain ; both tendon and bone giving way, 
the fetlock coming to the ground, &c. I have seen one case that 
goes to prove that mere fracture of the bone after this operation 
does not always cause inconvenience to the animal; and sub- 
joined are two woodcuts, of the navicular bone from a horse 




Figs. 15 and 16 show both surfaces of the Navicular bone, 
described iu the text. 

unnerved by me at the Veterinary College more than three years 
before he was destroyed. During the whole of- that time he 
performed his work well and soundly, and ultimately had to be 
put away, owing to the occurrence of necrosis of the os pedis. 



FKACTUEE OF THE NAVICULAB BONE. 139 

Upon examination, the navicular bone was found fractured, 
and the fracture reunited by false joint. I am of opinion that 
the fracture had occurred immediately after the operation, and 
that union had taken place very shortly afterwards. The case 
was under very favotirable circumstances, being driven in the 
cart by a very careful old man, and never pushed beyond a 
walking pace. 

The OS pedis is fractured in various ways : — 1st. By violence, 
as when the calkins of the shoe are entangled in a rail^n'ay point, 
the horse falling, and a large portion of the crust becoming de- 
tached, and at the same time the bone being lacerated. 2d. 
From the falling of heavy weights upon the feet. Bd. By con- 
cussion ; but before this form of fracture can occur the bone must 
be in a fragile condition, resulting from chronic laminitis. 4:th. 
From the prick of a nail in shoeing. This fracture may be 
immediate, or a piece of bone may become detached from the 
pressure of the nail, thus constituting a fracture by partial 
necrosis. 

The first kind may be considered beyond treatment, unless, 
indeed, the fracture be very slight, and easily removed. The 
proper treatment will be the removal of all detached horn and 
fragments of bone, the application of poultices, and the ad- 
ministration of febrifuges, with rest in the slings until the fever 
subsides. 

It is curious to observe how soon a portion of foot stripped of 
its crust is sheathed and coated over by the homy secretion of 
the sensitive laminae ; in a very few days, if the laceration of 
the soft tissues has not been great — where the horn is merely 
stripped off — ^it wiU be found that the soft structures are covered 
over by a layer of protecting horn, which prevents further irri- 
tation, and enables the patient to move the foot with comparative 
ease. Had the advocates of the hypothesis, that the horny 
laminae are secreted by the coronary substance, only remembered 
what they must have observed in the course of their practice, 
they never would have propounded such an absurdity.* After 
the pain and fever have subsided, the practitioner must deter- 
mine if a shoe can be applied with advantage or not. If it be 

» Notwithstanding the severe strictures of one critic, who states that the laminae 
do not secrete horn, I maintain my view that a horny secretion is formed by them 
independently of the coronary baud. 



140 EAETICULAK FKACTUEES. 

thought necessary, it must be a bar-shoe, made as light as pos- 
sible, and nailed to the uninjured part ; the foot is then to be 
enveloped in a soft dressing, consisting of fine tow, tar, and band- 
ages. But if the bone be broken into several fragments, or when 
it is cleft through its centre, and into the pedal articulation, it 
wiU be advisable to destroy the patient. 

The second and third forms are, as a rule, incurable. The last 
form is partial, but is always to be considered of great impor- 
tance, although by careful and timely treatment the results' may 
be satisfactory. The symptoms are those of pricked foot, with 
or without suppuration. At first it is impossible to say whether 
there is a fragment or not. But let the practitioner pbserve 
that, when the foot is pricked, the removal of the offending body, 
the paring out of the foot, and giving exit to the imprisoned pus, 
will, ag a rule, give relief Put if a portion of the bone be de- 
tached, the animal will continue as lame as he was prior to the 
treatnient,; or it will be found that the, pain and fever increase 
from hour to hour, abscesses form around the coronet, and the 
animal will die in great agony in the course of a viery short time. 

The treatment must be prompt. If it be found that relief 
does not follow the treatment appropriate for punctured foot, 
the practitioner must cut down on the pedal bone at the seat 
of the pain or suppuration, and explore. He wiD. find a loose 
fragment ; this he must remove as speedily as he can. It may 
be no larger than a small pea, or it may be the size of a bean, 
but out it must come. When this is effected, relief is generally 
obtained; the after treatment being poultices, cathartics, ano- 
dynes, and febrifuges. 



BROKEN RIBS. 

The attention of the veterinarian is but seldom called to this 
injury, yet post mortem examinations reveal in many instances 
that the ribs have been fractured at some time or other of the 
animal's existence ; the method of repair being always by the 
ensheathing callus. In none of these cases has there been any 
record of the accident, nor indeed would there be any symptoms 
present to indicate such, if the fracture had not been a compound 
one. 

The causes are direct violence, such as kicks from other horses, 
and blows. 



BROKEN RIBS. 141 

In compound fracture — the only kind that the veterinarian 
will he inost likely called upon to attend, as in simple fracture 
it is' rarely necessary to do anything — it may be found that the 
lung is wounded, and that the patient will he suffering from 
pneumonia. It might he supposed that collapse of the lungs 
would immediately occur upon the admission of air into the 
cavity of the thorax ; hut this does not take place to such an 
extent as one might imagine. The air will be found to rush in 
and out of the thorax through the wound at each respiratory 
movement ; that is, it wiU rush in during expiration, and out 
during inspiration. 

Treatment. — To find out if the lung is punctured, and if 
the fragment or fragments of the bone are displaced, and to 
replace them in their proper position. All this may be done 
by introducing the finger into the wound, and by converting 
the compound into simple fracture ; closing the external open- 
ing by a good stiff plaster — the Burgundy or the common pitch 
wiU do very well — to limit the movements of the chest by 
a broad belt, and to' watch carefully for signs of pleurisy and 
pneumonia. 

If called upon immediately after the accident, purgatives 
may be prescribed with advantage ; but should the case have 
been neglected until inflammation of the pulmonary organs 
begins to manifest itself, purgatives must be withheld, and 
sedatives, as aconite, with the nitrate of potash, administered. 

The ribs may be fractured, and the skin not broken, but 
when the subcutaneous tissues are bruised to a considerable 
extent, it wiE be almost impossible to diagnose the fracture. It 
may only be supposed to exist by the severity of the injury, 
and by the animal perhaps manifesting symptoms of pleurisy. 
It is a remarkable fact that broken ribs, when broken inwards, 
although it must be at the risk of wounding the lungs, are 
more readily repaired than when an opening is made externally; 
this is due to the spores, or organic particles contained in the 
atmosphere — being the germs of low forms of life discovered by 
the microscope, causing putrescence and suppuration. This fact 
will point out the importance of closing the wound of compound 
fracture, and also of arresting suppuration, if it has already 
commenced, by carbolic acid dressings. 



142 PAJITICULAE FKACTUEES. 

LUXATIONS, OR DISLOCATIONS WITHOUT FEACTUEE, 

Are very rare in our patients ; the most common forms are those 
of the patella of the horse, the head of femur and carpus of the 
dog, and that partial form which may be said to exist in what 
is termed " knuckling over " at the fetlock in the horse. It is 
said by some that the shoulder-joint is dislocated without frac- 
ture in the horse, and I am inclined to think that such a thing 
may occur, but it can only be very rarely met with ; the ana- 
tomy of the articulation, the broad and extensive head of the 
humerus, allowing the comparatively small glenoid cavity of 
the scapula a freedom and extent of motion which renders dis- 
location almost an impossibility. The following case, I think, 
proves that the injury can take place. A horse slipped and 
fell ; when he rose, one fore leg was found powerless, pendulous, 
shorter than its fellow, and bulging outwards at the shoulder- 
joint. He was taken to a stable, where he immediately lay 
down, groaned in agony, was very restless, and unable to rise 
to his feet. A practitioner, 'who was sent for, pronounced the 
shoulder to be out; he secured the animal's other legs by 
means of hobbles, applied ropes to the lame limb above the 
knee and at the pastern, and had several men to pull steadily 
at the ropes to cause extension. When all was ready, he slipped . 
his boots off, and suddenly jumped with force on the damaged 
joint, which immediately gave a kind of crack, and the bulging 
suddenly disappeared. The ropes and hobbles were now re- 
moved, the horse assisted to his feet, when he was found to be 
nearly well, and walked home, a distance of about three miles, 
that night. I was a boy at the time, but I remember the whole 
thing very vividly. The late Mr. Barlow was of opiaion that 
this dislocation was an impossibility; but when I mentioned 
the above case to him, he was much struck, and confessed that 
it was sufficient to stagger him. 

iMxation of the Patella occurs in young horses that are grazed 
on very hiUy pastures, from the mal- position in which the limbs 
have to be constantly kept, owing to the inequality of the 
ground. The patella is forced outwards; the iutemal lateral 
ligament becomes stretched across the internal prominence of 
the trochlea of the femur, and is thus torn or chafed. At first, 
the luxation is only partial, the patella slips in and out of its 



LUXATIONS. 



143 




position with a clucking noise at every step the animal takes ; 
very commonly hoth patellae are in the same condition. When 
the luxation is complete, 
the internal lateral liga- 
ment must be ruptured 
through its whole thick- 
ness, and the patella 
shps outwards. The limb 
now becomes stretched 
backwards; there is total 
inability on the part of 
the animal to flex it, 
owing to the action of 
the vasti, rectus femoris, 
crureus, &c., being inter- 
fered with. 

Treatment. — Forcible 
extension and keeping „,„.„,, , ., - t. • ^i, 

, T T ■ J} ^ Fig. 17. — Trochlea of the femur, showing the 

tne limb m a lorward effects of friction from luxation of patella, a, Ex- 
position by means of a ts'^^.l, and b, internal trochlea, d and c, Condyles 
. , . ,, of the femur. 

strong cord round the 

foot. The leg must be kept in this position by the cord being 
fastened round the neck of the animal for some hours ; a shoe 
higher at the toe than at the heels should be put on, with a 
projecting piece of iron at the toe, and a smart blister applied 
to the stifle. Professor Dick used to say that this would per- 
form a cure, even after the ligament had entirely given way, 
provided the animal were kept at rest. 

If the dislocation has been existent for any time, the articular 
cartilage on the surfaces of the trochlea and patella becomes 
worn by attrition ; the articular laminal layer of bone is then 
rubbed off, the cancellated tissue exposed, and there is a deposi- 
tion of porcellaneous material (porcellaneous deposit) in the 
opened-up Haversian canals, giving the articulating surfaces a 
shining or glistening appearance. A restoration of the animal to 
usefulness wOl be now a matter beyond possibility ; indeed it is 
hardly conceivable that a complete dislocation with rupture of 
the ligament can at any time be curable. 



144 PAKTICULAR FEACTUKES. 

■ Partial disolocation of the FetlocTc Joints, arising from diseases 
of the feet, over- work, or a natural tendency to " knuckle over," 
is an occurrence of ■which little need be said, and with the 
exception of rest and perhaps a blister, no treatment can be 
recommended.^ 

This form of unsoundness may also arise from relaxation of 
the binding ligaments, and this may be the result of chronic 
inflammation of them, leading to a degeneration of their proper 
structure, when they will be found pulpy, more or less thick- 
ened, and the areolar tissue which is amongst their fibres highly 
vascular. 

The head of the Femur may be dislocated in the ox, dog, and 
cat ; but in the horse this is an impossibility without fracture, 
owing to the fact that in the horse the "pubio femoral ligament " 
is found. This ligament arises from the head of the femur, passes 
from the acetabulum through the cotyloid notch, then runs along 
a grove on the under side of the pubis to the median line, where 
it crosses its fellow from the opposite side, forming a cross, X. 
and becomes finally lost in the faschia of the abdominal muscles. 
In this manner the head of each femoral bone is kept in position 
by the muscles of the opposite side of the abdomen. Eeduc- 
tion may be easily effected in the dog and cat by extension and 
manipulation, and the parts maintained in position by a stiff 
Burgundy pitch plaster ; but in the cow any treatment may be 
considered questionable, and if the animal is at all fat, she should 
be made into beef. 

The symptoms of this dislocation are similar to those of 
fracture, but there will be no crepitation. As a rule, in the 
dog and cat the dislocated bone wiU be found on the dorsum 
of the Uium. There will be shortening of the limb, and total 
inability on the part of the patient to perform the ordinary 
movements ; but should the dislocation be into the foramen 
ovale, the limb wiU appear longer than its fellow, and the foot 
turned outwards. 

Dislocation of the Carpus, or of one of the phalanges, is of com- 

^ Note. — Since the above has been in type, I have had the opportunity of dis- 
rooting a limb, where habitual "knuckling over" at the fetlock was found to Vie 
due to an arrested development of the extensor suffrayinis. The tendon of this 
muscle terminated at the upper' head of the metacarpus parvus exterhus, the' action 
of the extensor muscle thus terminating at the knee, and the fetlock knuckled over 
from the want of the support of its tendon. 



LUXATIONS. 



145 



mon occurrence in running dogs, especially greyhounds, 
easily reduced, but is very apt to return. 



It is 



DISLOCATION OF THE CERVICAL VEKTEBK^ WITHOUT FEACTUEE. 

An animal, in August 1871, was found unable to rise one 
morning, but with some assistance was got on to its feet, when the 
neck, which had been previously all right, presented the appear- 
ance shown in the annexed woodcut (Kg. 18). Four days after- 
wards it was sent to the College, a distance of about two miles, 
for my opinion. The animal (an old mare) walked with a slight 
staggering gait, knuckled over occasionally at the fetlocks, could 
eat well, and move the head up and down with a moderate 
degree of freedom. There was no swelling of the soft parts from 
bruising or inflammation, the prominence of the curve being 




Fig. 18. 

hard bone. Upon attempting to straighten the neck, the animal 
would become paralyzed in the limbs, this paralysis passing away 
when the pressure was removed from the neck. Being very old, 
she was ordered to be destroyed. When the neck was stretched 

L 



146 PARTICULAK FEACTUEES. 

by a cord to the wall, previous to the division of the carotid 
artery, she fell paralyzed, and died before she was bled. 

The post mx/rtem revealed that the luxation had been reduced 
by the stretching ; that the fibro-cartilaginous disc, between the 
third and fourth cervical vertebrae, was in a pulpy condition; 
that the spinal cord and its surroundings were but slightly 
affected ; and that there was no fracture. This case proves that 
there can be luxation without fracture ; that such a lesion does 
not prove fatal if the spinal cord is not pressed upon ; and that 
reduction — causing pressure upon the cord — may be followed by 
immediate death. I have heard of similar cases, but never saw 
one before. I have, however, seen another case since the pubh-' 
cation of the first edition of this book. 

Twisted or wry neck may occur from a variety of causes other 
than dislocation, such as over-stretching or bruising of the 
muscles of one side of the neck, causing inflammation ; or from 
rheumatism affecting them, inducing loss of function of the 
muscles of one side of the neck. It is also a symptom of hemi- 
plegia. These various conditions may be distinguished from 
luxation by the absence of the diagnostic symptom of the latter, 
namely, the sudden paralysis of the limbs when attempts are 
made to straighten the neck. 



DISEASES OF THE BONES AISTD AETICULATIONS. 



EXPLANATION OF PHOTO-LITHOGEAPH, PLATE I. 

1. Fragilitus Ossium, with fracture thiougli tlie body of tlie four- 
teenth dorsal vertehra. (1.) Large fragile osseous tumour, (2.) Liae 
of fracture. 

2. Ehetjmatoid Disease op Hip-Joint. (1.) Cotyloid cavity, show- 
ing porcellaneous deposit. (2.) and (3.) Addimentary bones, partially 
filling up the foramen ovale. 

3. Diseased Condition of the Os Calcis and Asteagalus, pro- 
duced by repeated bruising, the animal from which it was obtained 
being a vicious kicker. 

4. Osteophytes. Through the centre of the mass a canal is left for 
the passage of the flexor tendons, blood-vessels, and nerves. 

5. Ossification of the Flexor Brachii in chronic shoulder lame- 
ness. 

6. Necrosis Totalis of the Scapula. (1.) and (3.) show large 
cloacae or foramina grandia. (2.) represents the sequestral capsula 
The specimen from which this figure was taken was highly prized by 
Professor Dick. 

7. Caries op Superior Maxillary Bone and alveolar processes, 
arising from disease of the two anterior molar teetL 

8. True Mollities Ossium, or softening of bone, by absorption of 
the earthy salts, without alteration in animal basis. Case described 
in the text. 

9. Actinomycosis (Osteo-Sakcoma). Lower jaw of ox, the hollow 
spaces in the specimen, when fresh, being filled by sarcous material. 



CHAPTER VIII. 

DISEASES OF THE BONES AND ARTICULATIONS. 

CLASSIFICATION OF THE BONES OSTITIS-^SORE SHINS SPLINTS 

PECULIAKITY OF SPLINT LAMENESS SCROFULOUS OSTITIS. 

The diseases affecting the bones of the lower animals may, for 
the convenience of description, be classified under two heads, 
namely, inflammatory and non-inflammatory. The line of de- 
marcation between the two is not very well defined, as what may 
be essentially a non-inflammatory disease in itself might be 
productive of inflammation. Inflammation of bone (ostitis) can 
scarcely be considered independently of inflammation of the peri- 
osteum (periostitis), as both structures are so closely related that 
we caimot have inflammation of the one, without the other par- 
ticipating in the diseased action. 

A correct knowledge of the pathology of bone being of the 
gi'eatest importance to the veterinarian, and the study of this 
particular branch of veterinary pathology having hitherto been 
neglected by the profession, I feel it necessary to give a slight 
outline of the general anatomy of bone, in order that its patho- 
logy may be better understood. 

Bones are divided into long, short, flat, and irregular. With 
the exception of the cranial bones, the short, irregular, and flat 
bones are coniposed chiefly of cancellated tissue enclosed in a 
thin shell ; and it is found that, owing to their structure, they, as 
well as the extremities of the long bones, undergo pathological 
changes somewhat similar to those of the softer structures. 

The bones of the cranium are composed of two bony plates — 
a very dense one internally, another less dense externally, and 
an intermediate vascular and medullary structure. 



CLASSIFICATION OF THE BONES. 149 

The long bones consist of a shaft and two extremities, or 
epiphyses, which are much looser in structure than the shaft, 
are developed separately from it, and are supplied by numerous 
blood-vessels passing directly into them. The shaft is com- 
posed of very hard tissue, encloses a cavity called the medul- 
lary canal, and on its outside a number of small lines or grooves 
are to be seen, which are the oblique openings, through which 
vessels pass from the periosteum into the dense structure of the 
bone. 

The bones of race-horses contain more compact tissue in their 
shafts than those of lower-bred animals. The dense struc- 
ture — compact tissue — contains the Haversian canals, conveying 
blood-vessels ; and the canaliculi, which are smaller canals con- 
veying blood plasma to the lacunae. In this manner this portion 
of the bone receives its supply of nutritious material from 
the blood, and without this arrangement the bony structure could 
not receive nutrition. Each Haversian canal is about -j-^ of an 
inch in diameter, and collectively they run in a longitudinal 
direction, but have many transverse branches of communication. 
The canaliculi average xi.i^-u of ^^ i^^l* ^^ diameter, and appear 
as dark radiating lines, decreasing in diameter as they recede 
from the lacunae ; they are, along with the lacunae, filled with 
the fluid, colourless portion of the blood. 

The lacunae are irregularly oval, stellate, dark-looking bodies, 
lying with their long diameters, which are about i^nr of ^^ inch, 
parallel to the bony lamellae. Each long bone is, in addition 
to the periosteal vessels, supplied by a nutrient artery, which 
passes directly into the bone, and breaks up into branches in 
the interior of the medullary canal. 

It will be seen that the compact bone is abundantly provided 
with vessels, entering from numerous points, covered by perios- 
teum and endosteum; that these nutrient vessels are exceed- 
ingly minute, and surrounded by a dense structure ; and that, 
in consequence of this peculiarity, the effects of inflammatory 
action will be very distinctive, and the symptoms most acute. 
Fortunately, however, inflammation of the shafts of the long 
bones is exceedingly rare in the lower animals. The extremi- 
ties or epiphyses of the shaft are, as already stated, developed 
separately from the shaft, and they exceed it in circumference, 
are irregular in outline, expanded, roughened externally, and 



150 DISEASES OF THE BONES AND AETICULATI0N3. 

composed of cancelli, with a very thin layer of compact tissue. 
Whilst they are of greater circumference, their weight is not 
relatively greater than the shaft, their increase being due to 
an expansion of substance. This arrangement lightens and 
strengthens the bone, and modifies inflammatory action, which 
consequently partakes more of the nature of that of the soft 
tissues. 

The hardest part of the bone is a thin laminal layer, lying 
next to the articular cartilage. It is non-vascular, insensible, 
and destitute of Haversian canals, and, in iniiammatory disease 
of the articulations, it is affected in a remarkable way, which 
win be referred to hereafter. 

Each long bone has a canal in the centre of its shaft, called 
the medullary canal, which is not continued to the extremities. 
It contains meduUa or marrow, and is lined by a dehcate 
vascular membrane, the endosteum, which is prolonged into 
the cancellated structure and Haversian canals. It is supplied 
with blood by the nutrient arteries, which anastomose with 
those supplied by the periosteum. 

The periosteum invests the whole bone, except its articular 
extremities. It is a complex structure, consisting of a fibrous 
membrane, and a lining of germinal or nucleated membrane ; 
both of which are continued into the Haversian canals. This 
inner lining assists in the formation of new bone, but the 
fibrous portion has no formative power. 

Many experiments have been made to prove that the 
periosteum possessed this formative power, but they are still 
inconclusive; and the only practical dediiction obtained is, 
that when it is destroyed, there is a want of nutrition and 
reproductive power, in proportion to the destruction of the 
formative membrane and the vessels passing along with it to 
the substance of the bone. 

The presence of this formative membrane, internal to the 
fibrous coat, will at once explain how subperiosteal exudation, 
as in the case of splints and other exostoses, is converted into 
bony structure. 

Having in view all the peculiarities of structure found in 
the various bones, we wiU now consider the diseases affecting 
them. 



OSTITIS. 151 

OSTITIS, OE INFLAMMATION OF BONE, 

May be acute or chronic. It may involve the whole substance 
and extent of a bone, or it may be confined to a portion of it 
(circumscribed inflammation). The causes are external injury, 
concussion, and hereditary tendency. 

Acute inflammation of bone, involving the shaft, is found to 
affect young race-horses in the disease termed "sore shins." 
This disease usually involves the periosteum and external 
layer of the bone only; and such cases terminate by a 
deposition being thrown out between the periosteum and the 
bone, which, becoming organized, forms a permanent thicken- 
ing, depending more or less upon the degree of the diseased 
action; but in rare cases the whole of the bone is affected, 
and the inflammation is of such an acute nature that the 
vitality of the bone is destroyed; the exudation blocking up 
the Haversian canals and canaliculi, and thus arresting the 
nutritive functions. The dense structure of the bone does not 
permit the blood-vessels to relieve themselves by pouring out 
their liquid contents, as in the softer tissues, and the part dies 
by the pressure on its vessels, even when the diseased action is 
not sufficiently active to produce this death of the bone. Ac- 
cording to Goodsir, the first changes that occur in the bone are 
to be distinguished within the Haversian canals. These dilate 
or become opened up ; and the result of this is the conversion 
of the contiguous canals into one cavity, and the consequent 
removal or absorption of aU the osseous texture of the part. 

Concurrent with this softening and opening up of the 
bony texture, an external swelling makes its appearance ; the 
vessels of the periosteum and contiguous soft parts, becoming 
involved, throw out a deposit upon the surface of the bone. 
This exudate, as a rule, becomes converted into bone, leaving 
the parts permanently altered in shape and appearance ; or it 
may become absorbed before it is ossified, and the parts regain 
their former condition. 

The results of inflammation of bone, where resolution does 
not take place, are either an increased condensation or an 
abnormal rarefaction. Of both these forms we have good in- 
stances in most cases of ostitis, whether occurring in the 
navicular or other bones, (See figures of Navicular Bones.) 



152 



DISEASES OF THE BONES AND ARTICULATIONS. 




Fig. 19. — Inferior extremity of tibia 
in a healthy condition, a, Laminal layer. 
b, Cancellated tissue. 



In the first form, the Haversian canals and the cancellated 
spaces are blocked up by earthy matters, which give to the bone 

an ivory-like appearance when 
sawn across ; at the same time 
the bone is heavier and denser. 
In the latter, or rarefaction of 
bone, there is a diminution of 
its density and weight, owing 
to its tissues being expanded, 
and to its canals and cells being 
enlarged, with thinning of its 
osseous layers, and the forma- 
tion of communications between 
its various interspaces. Whilst 
this is going on, the outer sur- 
face of the bone may become 
thickened by a deposition of new bone, or it may be removed 
by absorption ; or both conditions may be co-existent upon the 

same surface of the bone 
(see Fig. 20). Of this we 
have other examples in 
navicular disease, where 
small nodules of bony mat- 
ter are often found conti^ 
guous to a pit-like ulcer, 
Again, it is generally found 
that when this loss of sub- 
stance goes on within the 
bone, and upon its articular 
surface, as in ostitis caused 
by open joint, that there is 
„„ _ ^ . i .^ . ^., . . an active process of de- 

FlG. 20. — Interior extremity of tibia in a . . ^. 

state of ulceration, a, Thickened laminal layer, position going on Upon 
b. Carious spot, c, Cancellated tissue opened its periosteal surface ; and 

this may be looked upon 
as a process of repair contemporary with that of destruction. 
During the early stages of the process of rarefaction, the bony 
texture is found softened, and has a porous appearance; but 
later on the effect is to render the whole substance of the in- 
flamed part more brittle and liable to fracture, as in the case of 
" fractured spavin," fractured navicular bone, &c. 




OSTITIS. 153 

The outer surface of the inflamed bone presents a spongy- 
appearance, from a deposition of new bone ; the periosteum is 
thickened, and in the more acute cases it is detached from the 
bone, which, when exposed, has a white and smooth appearance, 
with hardly any change in its stnicture, the diseased action 
having been too rapid to allow it to open out. 

When the inflammation is of the chronic form, the patholo- 
gical changes occur more slowly, and when different parts of a 
bone are affected, new osseous material is deposited here and 
there, giving the bone an irregularity of shape, as in multiple 
splints. 

A very moderate degree of inflammation in the outer lamella 
of bone, produces a gelatinous, dark red exudation, which gradu- 
ally changes its colour to bluish-red and reddish-white, and at 
length becomes CLuite white ; at the same time, passing from its 
original gelatinous condition, it forms a coagulum, like the white 
of an egg, then becomes a soft flexible cartilage, and finally 
reddish-white succulent bone. In this state it invests the bone, 
and constitutes, according to its quantity, either a white, porous, 
and scarcely perceptible film, or a thicker layer, that resembles 
felt or velvet. The periosteum appears at first injected, bluish- 
red, iafiltrated, and decidedly swollen, and generally has but a 
loose connection with the exudation. The ossified exudation 
anites with the surface of the bone, and either forms uninter- 
ruptedly an addition to the compact wall, or is connected with 
it by a spongy layer (diploetic). The inflammation may recur in 
the exudation at any period of its existence, leading to a corre- 
sponding increase in its size. 

Such, then, are the general outlines of the various changes that 
occur consequent upon inflammation of bone. 

OSTITIS AND PERIOSTITIS OF THE METACARPAL BONES, OR 
" SORE SHINS." 

This is a form of disease affecting the metacarpal bones of 
young horses, particularly race-horses under four years old, and 
is due to the fact that they are called upon to perform an 
amount of work at an age when the condition of their bones is ■ 
totally unfit to bear it. 

The bones of the young, being in a state of development 



154 



DISEASES OF THE BONES AND ARTICULATIONS. 



and growth, are much more vascular, and contain a greater 
quantity of animal matter than the bones of those of mature 
age ; they are consequently unable to stand the shocks of con- 
cussion, to which they are subjected in their training. 

Sore shins may affect the M'hole shaft of the bone (see Fig. 21), 
and may be so excessive as to cause necrosis to supervene ; but 
usually the inflammation is circumscribed and confined to the 
lower extremity and anterior portion of the bone. The leg with 
which the animal leads in the gallop is 
more Liable to be affected than its fellow. 
Symptoms. — Lameness occurring after 
a gallop, insidious at first; the horse 




restless, shifting his 



weight from 



one 



leg to the other if both legs are affected, 
or, if only one, standing with his foot 
pointed. If the inflammation is acute, 
there will be fever, with acceleration of 
the pulse and respiratory movements, and 
the bones are sensitive when pressed 
upon. Swelling is an early symptom; at 
first it is elastic, tense, and doughy to the 
touch ; it depends on the thickening of 
the periosteum ; and on the presence of 
a subperiosteal exudate ; afterwards, the 
swelling may become oedematous, from 
effusion into the areolar tissue external 
to the periosteum, but it always main- 
tains the elastic feel underneath the 
CEdema. 

If the subperiosteal exudation is 

very great, and the swelling involves a 

large extent of the surface of the bone, 

the most active treatment must be 

employed in order to prevent necrosis. 

In some rare cases, the exudate becomes 

converted into a thin, sanious matter, 

which corrodes the surrounding tissues, 

causing great febrile disturbance, and may cause the death of 

the patient, from its absorption into the general circulation. 

In the less acute cases, where the cause has been less severe, 



Fig. 21.— Sore shin. 



OSTITIS AND PEEIOSTITIS OF THE METACABPAL BONES. 155 

the disease is more circumscri'bed and more limited in its 
effects, or the limbs of the animal have been more able to bear 
it ; it becomes ultimately quite hard, from the organization of 
the exudate into bony matter, and when this is effected, the 
lameness and pain generally disappear. 

In the acute and extensive form, when the exudate does not 
break down into sanies, or when suppuration does not imme- 
diately take place, it becomes after a time hardened, and finally 
converted into an ensheathing ring or case of new bone around 
the old bone, forming a support for the limb, as will be de- 
scribed under Necrosis. 

The treatment of the acute form is by free subcutaneous 
incisions through the periosteum ; this will relieve the pain, cut 
short the disease, and by allowing the exudate to escape, will 
prevent the separation of the periosteum from the bone, a result 
to be dreaded in every acute case, as leading to the necrosis of 
the bone by the removal of its blood supply. In addition to 
this, warm and , soothing fomentations are to be used at first, 
succeeded by cold, and afterwards by blisters. The constitu- 
tional treatment to consist of a smart purgative, followed by 
alteratives or sedatives, with low diet, and the animal to be 
kept as quiet as possible. In the less severe form, incisions 
are not called for, and the cold application may be employed 
from the outset, succeeded by blisters, as in the acute form. 



SPLINTS 

Are another form of ostitis and periostitis, affecting the 
metacarpal bones, and, in rare instances, the metatarsals. They 
have a great analogy to the last-named disease, differing 
only in situation ; splints being usually found upon the inner 
surface of the leg, involving the inner small and large meta- 
carpal bones, whereas the other form is usually found upon the 
surfaces of the lower third of the large bone only. The reason 
for this may be found in the pace of the race-horse being the 
gallop, in which the weight of the animal's body is thrown 
upon the anterior portion of the bone with fearful velocity at 
each successive bound, causing the inflammation of the bone 
in that part by which the shock is received. Splints, on the 
other hand, are caused by a moderate pace, the trot or gentle 



156 



DISEASES. OF THE BONES AND ARTICULATIONS. 



gallop, where the animal is more kept up to the bridle, , and: 
the weight thus thrown more directly upon the upper extremity 
of the bone, and is thence transmitted to the seat of splint, in; 
the same way as a blow will cause an indirect fracture, as already 

explained. As a rule, the inner side 
of the upper third of the metacarpals 
is the seat of splint ; but, owing to 
peculiarity of form and shape of the. 
leg, the deposit may be found upon the 
outer side, or both upon the inner and 
outer, and middle aspect of the limb. 
Percivalldescribes five classes of splints : 
1st. Simple. 

2d. Double or pegged splints ; that 
is, those which are found upon both 
aspects of the limb, with an osseous 
communicating bar running from one 
to the other. 

3d. Those close to the knee. 
4:th. Consisting of two or more 
exostoses upon one side of the leg, 
one above the other, with perhaps an 
osseous communication. ■ < 

5th. Little bony excrescences, in- 
volving the knee-joint, namely, the 
head of the metacarpus minor inter- 
JollfihT'rermetaSSnus, and trapezoid, or metacarpus 
bones. a,lnter-metacarpal groove, minor externus, and unciform. 
V.TXXoZoT::^XZ- a simple spUnt, when not causing 
volving the extremities of the lameness, and in a position removed 
u^:X^^elt:7,t^:Z:J^'om either articulation or tendon, is 
lar ossifications, involving the not looked upon as an unsoundness, 

small metacarpals, lower end of , , n , -i ii, .f j. i i ■ 

large metacarpal, and forming ^ut all tne other formS must be claSSl- 

points of attachment to the supe- fled as causes of Unsoundness, as they 

rior sesamoidean Hgament above , . . t i i j i 

its bifurcation. are at any time liable to cause lame- 

' Note.— The more important por- ness<; and are indicative of more 

tions of this forai of splint, namely, ,. ^ . j •,t ■ i J^ 

those invoivinK the ligamentous stvnc- disease than IS apparent either to the 

tures, are hidden from view in the , i p j i • t 

living suhjeet. cyc ov touch 01 the examiner ; disease 

involving articulating surfaces, ligamentous structures, or inter- 
fering with the movement of a tendon. ....... 




SPLINTS. 157 

Professor Dick taught that a splint never interfered with the 
action of the flexor-pedis tendon ; that the soft parts adapted 
themselves to the hard ; and that, although a splint might press 
upon the tendon, a corresponding hoUow was made for it by 
absorption of the softer structure. I cannot agree with this. 
Experience has proved to me that it is wrong, and that the 
lameness, depending upon the interference of the splint, can be 
completely cured by the removal of the deposit. 

A simple splint on the outer side of the leg is more apt to 
cause lameness than one on the inner side. 

The causes of splints are concussion and hereditary predis- 
position, more especially that arising from shape and form of 
leg, which descends from parent to offspring. 

Splints are most generally found in horses that are newly 
put to work, or they may arise in the unbroken colt when he 
is allowed to gallop and play in the fields. The class of horse 
most subject is the lighter-bred horse, or that which is called 
upon to go beyond a walking pace. Heavy cart-horses seldom 
have splints ; but I see no reason why they should not, provided 
their legs were subjected to the same amount of concussion. 

Splints are exostoses due to a circumscribed superficial in- 
flammation of the bone and periosteum, and not inflammation 
of the interosseous ligament, as described by some writers. 
Numerous specimens in the College Museum prove the cor- 
rectness of this view. The effects of the concussion which 
produces this form of ostitis may be due to the immature age 
of the bone, to peculiarity of shape in the leg, to the method 
by which the animal is shod, or to work at an early age. Old 
horses throw out splints occasionally. 

Splints do not always produce lameness. If of the simple 
kind, when the horse is very young, and before he is broken in, 
lameness is but seldom seen ; and when over six or seven years 
of age, he seems exempt from lameness, although the deposit 
might be of considerable size. 

When simple splints cause lameness, it is during their forma- 
tion, that is, during the inflammatory stage, and before the 
periosteum has adapted itself to the pressure. The young 
:horse of good action is the one most likely to suffer, as the 
effects of shock or concussion are greater and more destructive 
to his limbs than to the limbs of a horse with lower action. 



158 



DISEASES OF THE BONES AND AKTICULATIONS. 



PEGULIAlilTY OF SPLINT LAMENESS. 

The lameness may precede the ap- 
pearance of any swelling or deposit-, and 
in such a case it is apt to be confounded 
with that arising from other diseases. 
But if the following observations are 
kept in remembrance, no mistake need 
be made : — - 

1st. The age of the animal. The 
young horse is most liable to splint 
lameness, the older hoise to navi- 
cular disease. 

2d. The peculiarity of action. , A 
horse lame from splint will walk ap- 
parently or nearly sound, but will 
trot very lame, the drop of the head 
and body upon the sound side being 
very great, and out of all proportion 
to the apparent soundness of the walk. 

od. A want of flexion may be ob- 

Fig. 23. -Ordinary form of ^^^^^^ ^^ ^^"^ k^^e. 
splint on the inner side of near Ath. When the patient first COmeS 

indsmlllLTSalflnti: ^^t, and is made to trot, he may go 

' ■ moderately sound, but after a time 

the lameness increases, the concussion 
disease the lameness 
generally decreases with exercise. 

5th. Pressure upon the j)art of the leg where splint is likely 
to be will cause pain ; some heat is present ; and, by a careful 
manipulation, a hard swelling perhaps smaller than a pea may be 
felt. In some cases the exostoses soon develop themselves, and 
then there can be no further difficulty ; but in others, this does not 
occur for several weeks, and these are most unsatisfactory to the 
surgeon. In some rare cases the lameness is very excessive, 
the horse being scarcely able to put any weight upon the 
affected limb ; standing with the toe only touching the gi-ound, 
with great heat and swelling of the part affected, at the same 
time suffering from constitutional disturbance to a considerable 
degree. In such a case, the treatment must be prompt, to 




ongnial specimen the inter- 
osseous liga.ment is not ossified. 



being a cause of pain. In navicular 



PECULIAEITY OF SPLINT LAMENESS. 159 

relieve tlie animal from its sxifferings, and the best is "sub- 
cutaneous periostiotomy/' as recommended by the late Professor 
Sewell. 

The operation is performed by making a transverse incision 
with the Towelling scissors, immediately below the enlargement, 
introducing the " periostiotomy knife " flatwise under the skiu| 
as far as the upper end of the splint, turning the cutting edge 
inwards on to the bone, and cutting through the periosteum 
into the new formation. It may be necessary to cast the horse, 
but, as a rule, the application of cocaine and the twitch keeps 
him quiet enough. 

Some practitioners pass a seton over the deposit after the 
operation, and I recommend it as good practice. 

In all cases a purgative must be administered ; and in the 
milder forms, fomentations and the application of a coolino' 
lotion are quite sufficient to remove the inflammation and 
lameness ; but if they fail to do so, a blister should be applied, 
and in obstinate cases it may be found necessary to fire the 
part, the method by pyro-puncture being preferable, as it leaves 
but little blemish ; the instrument to be made hot, and applied 




Fig. 24. — Instrument for pyro-puncture. 

with sufficient pressure to pierce the skin, and to enter the new 
deposit. 

If there be a return of lameness when the patient is put to 
work after an apparent cure, it will be advisable to take the 
shoes off, turn him into a loose place, and allow a long rest. 
When the deposit is sufficiently prominent to interfere with 
the action of the flexor tendon, the treatment is to cut down 
upon it and remove it by the bone forceps or Volkmann's spoon. 

Sometimes the splint is large enough to interfere with the 
action of the opposite fore foot, that is to say, it is liable to 
be struck by the other foot during rapid action. In such a 
case a boot must be used, and the absorption of the deposit 
excited by the application of the ointment of the biniodide 
of mercury ; or if it be a sharp, prominent splint, it is to be 
removed by the bone forceps. This striking of the enlarge- 
ment with the opposite foot is apt to cause the horse to fall, 



160 DISEASES OF THE BONES AND AETICULATIONS. 

from the suddenness and violence of the pain, or to induce 
inflammation in the splint, and very severe lameness. 

Splints in the hind legs seldom cause lameness; they are 
usually upon the outer side of the metatarsal bone. There are 
many examples of ostitis that will be described more appro- 
priately under the head of lameness. Sore shins and splints 
are perhaps the only ones, usually met with in practice, of in- 
flammation of the compact shaft of the bone ; the other forms being 
found attacking the cancellated structure composing the short 
and iiTCgular bones, and the extremities of the long ones. But 
before passing on to these, I shall describe scrofulous inflanxma- 
tion of bones, caries, necrosis, and the non-inflammatory diseases. 



SCROFULOUS OSTITIS IN YOUNG ANIMALS. 

Scrofulous ostitis is found in very young animals, usually in 
those of a few days or weeks old. I have seen it in foals, calves, 
and lambs, and in older animals, as malignant " foul in the foot " 
of horned cattle. Professor Dick taught that pigs were subject 
to it. The following is the pathological anatomy of a case of 
" foul in the foot " arising from scrofula, occurring in my own 
practice. 

The animal was a two-year-old heifer, which had been suffer- 
ing for about five months from foul of the foot ; having defied 
all the ordinary remedies to effect a cure, and the fact that 
several animals on the same farm, and of the same breed, were 
similarly effected, induced the veterinary surgeon in attendance 
to send one of the affected feet of this malignant case to the 
College for examination. 

The part sent was a fore foot, having been cut through about 
the lower third of the metacarpus, showing the fetlock joint and 
the two complete digits attached. — (See Photo-lithograph, Plate 
II., Figure 9.) 

In external appearance it was very much swoUen, and studded 
round with ulcers of various shapes and sizes, from that of a six- 
pence to that of a halfpenny. The fetlock joint was completely 
open on the right side, and deep ulcerations of the articular sur- 
faces of the bones had taken place, more particularly of the 
.trochlea of the metacarpus. 

On attempting to remove the skin, it was found closely ad- 



SCROFULOUS' OSTITIS. ' 161 

herent to the subcutaneous tissue, and intimately blended with 
it. The subcutaneous substance consisted of an inflammatory 
exudate of considerable thickness, having a pale bluish appear* 
ance, a vitreous character, and quite structureless ; it was so 
intimately infiltrated within the textures of the tendons and 
ligaments beneath, that it was with difficulty detached from 
,them. 

Throughout this exudate were a number of sinuses of various 
sizes and figures, containing a yellow semi-fluid, granular-look- 
ing substance, which, on examination with the microscope, pre- 
sented all the characteristic appearances of tubercular pus, and 
a very few tubercle corpiiscles mixed with it. 

The cavities in which the substance was contained varied in 
size from a pin-head to that of a hean, the smaller ones being foi? 
the most part circular in flgure, while the larger ones varied very 
much, their form and outline making it evident that their en- 
largement was due to the confluence of two or more smaller 
ones. Notwithstanding the number' of these little cavities, ther^ 
was very little of that apparent inflammation in the inlmediately 
surrounding textures which we invariably find in the formation 
of an ordinary abscess. 

On making a longitudinal section bi the bones, I found in the 
first or upper phalanges not only the medullary canal filled with 
lymphoid material, but the whole of the cancellated tissue eh-" 
tirely replaced by that substance. The bones of the second or 
middle phalanx also contained a considerable quantity of it, but 
there was no ulceration of the articular extremities. There was 
a slight calcareous-looldng deposit on the bones' of the first 
phalanx, but on examination it had no bony structure. 

The old writers described this disease as "joint-ill," and 
ascribed it to rheumatism. I am of opinion that they were 
wrong, as in its progress it differs most materially from rheuma- 
tism. If the patient be under three or even four weeks Old, the 
first noticeable sign of the disease is a dribbling of urine from' 
the umbilical cord. In fact, the urachus has again become per^ 
vious, and allows the urine to escape, although the urethra is 
quite in a normal condition, the animal having been seen to 
urinate in a proper manner. Concomitant with this unnatural 
flow of Urine, the patient will be found stiff and lame in one, two, 
or more of its limbs or joints ; the affected parts are swoUett; 

M 



162 DISEASES OF THE BONES AND AKTICULATIONS. 

hot, and tender ; the respirations hurried ; but the appetite re- 
mains tolerably good for some time ; the swollen joints suppur- 
ate; and the disease is now complicated with open joint; abscesses 
form on various parts of the body, the patient loses flesh, be- 
comes unable to rise, and dies, a miserable object. 

The causes are extrinsic and intrinsic. 

The extrinsic are exposure to cold, a bad mother — ^that is to 
^ay, a mother that is without sufficient milk for the foal — ^long 
fasting, as in cases where the mother is put to work shortly 
after the birth of the foal, and only allowed to suckle her 
young two or three times a day. I have seen the disease 
produced in pet lambs when brought up on cow's milk ; these 
circumstances produce debility of the constitution, indigestion, 
and mal-assimUation, 

The intrinsic cause is the scrofulous diathesis, and this may 
arise independently of any external circumstances. 

Pathology. — To understand this correctly, it must be re- 
membered that the growth of the bones is very rapid in young 
animals, and that a large quantity of blood is required in the 
part, in order to supply the nutritive plasma for such growth ; 
in fact, the bones, more particularly their extremities, are in a 
state of healthy congestion. The blood supply must be abun- 
dant in quantity, and healthy in quality ; but in this disease 
the latter condition is absent ; and instead of supplying healthy 
material for the growth and nourishment of the bones, it con- 
veys a degraded form of an albuminoid matter, which is de- 
posited in the structure of the bones, and there excites a form 
of strumous inflammation leading on to caries, the removal of 
the articular cartilage, and the formation of abscesses in and 
around the joints, which make their way through the ligaments 
and synovial membrane, and burst externally by many openings, 
which communicate with the joint by circuitous sinuses. At 
the same time tubercular material is deposited in the cancelli 
of the bone, which is also found abnormally vascular and much 
softened. The urachus is also fiUed with a deposit of this 
tubercular matter, which, by preventing the completion of the 
process of adhesion naturally taking place between its walls, 
allows the escape of the urine at the umbilical region. 

The probabilities of effecting a cure wUl much depend upon 
the severity and situation of the arthrodial inflammation. If 



SCKOFULOUS OSTITIS. 163 

the larger joints, or those having extensive motion, as the true 
hock-joint or elhow, be already opened by the suppuration, the 
case may be looked upon as hopeless. 

If treatment is to be adopted, it must in the first place be 
directed to the removal of all extrinsic causes ; secondly, to pro- 
mote a better condition of the system generally ; and thirdly, 
to modiiy the local manifestations of the disease. 

In order to promote a better tone of the system, attention 
must be paid to the state of the digestive organs. Diarrhoea 
may be present, the faeces containing clots of curdled milk, 
mixed with much mucus, foetid in odour, and irritating to the 
anus ; or the bowels may be constipated. In both conditions, 
a very gentle laxative, as four ounces of castor oil, with two 
drams of the bicarbonate of soda, may be given ; and when 
the bowels are restored to their proper state, a pint of lime 
water in a little milk two or three times daily, in addition to 
half-ounce doses of the syrup of the compound phosphates or 
" chemical food" twice per day. I can speak with great con- 
fidence of the phosphates as being most beneficial in all debili- 
tating diseases of young animals. Great care must be taken to 
see that the patient suckles its mother sufficiently often, and 
if he be unable to stand to do so, he must be lifted and held up. 
If the mother has not sufficient milk, the deficiency must be 
supplied with cow's milk, care being taken that this does not 
constipate the bowels; the addition of a small quantity of 
sugar and water to it will be useful. The mother must rest 
from work, and be supplied with good food ; a mixture of beans, 
oats, bran, and grass if in season, will be most suitable. 

The lime water is recommended as an antacid. At one time 
it was supposed to supply lime to the bones ; it is now held that 
the bone diseases of the young are not due to the want of lime, 
but to its elimination from the system by the kidneys. Autho- 
rities, however, are divided upon this subject. 

The Local Treatment.— U. the uraehus be penrious, the patient 
is to be cast, and a suture tied round the umbilical cord. In 
performing this operation, the following rules ought to be 
remembered :—ls^. No rope is needed to throw a young foal. 
2d. The suture must be thick, as thick as the cord which is used 
for window blinds, and made of string or cord, in preference to 
metallic wire or caustic clam, for the following reasons :— that 



164 DISEASES OF .THE BONES AND AETICULATIONS. 

rapid sloughing of the portion included is to be avoided ; that 
the adhesion of the urachus is most likely to be produced by 
firm but not violent pressure ; and that the thick suture is less 
likely to cuf through the structures which it encloses than a 
thinner one, or suture wire, and not so liable to irritate and 
annoy, by its ;weight and presence, as the clanii 

The application of the suture must be in the form of a stitch, 
the skin being pierced by the needle on both sides of the urachus, 
and the suture tied round it as a loop. "When thus applied, 
there is no danger of its slipping off. The practitioner must 
not be afraid to take a deep hold, and enclose plenty of skin 
in the suture, in order that the adhesive action may surround 
the opening, and thus be a future support to the more tardy 
adhesive action of the mucous lining. 

The formation of healthy lymph within the urachus will be 
much favoured by injecting, before the suture iS applied, a 
solution of nitrate of silver, ten grains to the ounce of water. 

If the parts enclosed in the suture should slough off, and the ■ 
flow of urine return whilst the patient is otherwise improving, 
the suture riiay be again applied ; but if the general symptoms , 
have become worse, the sufferer should be destroyed, as the non- 
unioh of the urachus indicates that the material formed in and 
around it is aplastic, and not fitted for permanent repair, or to 
be converted into proper tissue. 

In conclusion, it must be always remembered that the health ■ 
of the mother plays a niost important part in the production and 
removal of this disease, and must upon all occasions demand the 
veterinary surgeon's care and attention. 



CHAPTER IX. 

DISEASES OF THE BONES AND ARTICULATIONS — Continued. 

ULCEKATION CARIES NECROSIS CENTRAL AND SUBPERIOSTEAL 

SUPPURATION ABSCESS IS THE SUBSTANCE OF A BONE. 

Weitees upon human surgery make a distinction between 
ulceration of bone and caries, both conditions being associated 
with the formation of pus. Thus, Professor Syme says — " By 
ulceration we mean that condition of bone in which there is 
loss of substance, together with suppuration, but in which the 
ulcer has a tendency to heal. In caries, on the contrary, while 
there is a loss of substance, together with suppuration, there is 
so far from being any tendency to heal, that healing is very diffir 
cult to accomplish." The same authority, quoting from Listen, 
says : — " It may tend to prevent confusion of the two morbid 
states, if we confine the term ulceration to suppuration in and 
absorption of bone, whilst the vessels retain a considerable 
power of action, throw out new matter, and procure a repara- 
tion of the breach; and this condition of the osseous tissue 
exists when the disease is situated on the surface of the bone, 
and when it has been induced by an external cause. On the 
contrary, the term caries will denote that particular kind of 
ulceration in which reparation is hardly attempted by nature, 
and is with difficulty obtained by the most active influence, 
and this disease will be most generally found to affect the 
cancellated structure. 

To the veterinary pathologist this difference is not at all 
satisfactory, and it may be laid down as a rule that ulceration 
of bone with a discharge of pus is the result of external injury— 
that, in fact, there is necrosis, or actual death of a layer of 



166 DISEASES OF THE BONES AND AKTICULATIONS. 

bone, more or less deep, as the case may he, the injury being 
inflicted upon a part of the bone other than its articular end ; 
whUst caries is confined to the extremities of the long bones 
and cancellated structure of the short and irregular bones ; and 
when not caused by external injury, is unaccompanied by the 
formation of pus. Of this we have many examples in navicular 
disease, bone-spavin, ring-bone, &c. 

Professor Spence says, that " The peculiar obstinacy of a 
truly carious surface arises from the fact that a large part of it 
is really dead." This, in my opinion, is necrosis, and when the 
necrosis occurs in our patients, it is always accompanied by sup- 
puration. I shall, therefore, distinguish these two terminations 
of ostitis, when not caused by external injury, as — 1st. Caries or 
removal of degenerated bone tissue by absorption without sup- 
puration, commonly found to exist in the articular ends of the 
bones; and, 2d. Necrosis, or death of a bone, or a portion of 
bone, accompanied by suppuration; the dead bone being removed 
by expulsion or surgical interference. 

Caries may arise from traumatic or idiopathic inflammation 
of the synovial membrane, or from ostitis commencing in the 
cancellated structure of the bone, and it may be defined as a 
slow absorptive process by which the bone becomes eroded and 
cribriform in appearance, the absorption extending to a distance, 
the bone converted into a brittle mass, and the surrounding 
parts more vascular and swollen than in the normal state. Or the 
destructive process is limited, by a deposition of bony material 
within the cancellated structure of the bone, rendering it of an 
ivory-like appearance when cut into, and increasing its density 
and weight. — (See Fig. 20, page 152.) 

Caries commences in the interior of a bone, and makes its 
way outwards; the bone acquires a red hue; its articular sur- 
face becomes soft; its laminal layer and articular cartilage are 
removed, exposing the cancellated structure, from which vascu- 
lar processes shoot out in the form of red teat-like granulations; 
the surface of the opposing bone — forming the articulation — 
becomes similarly diseased, the granulations from the one bone 
coalesce with those from the other, and form a vascular connec- 
tion between the interior of both bones. In this manner the 
process of anchylosis is commenced. 

When caries is situated in a bone over which a tendon plays. 



CARIES. 167 

as the navicular, sesamoid, or bicipital groove of the humerus, 
the fibres of the tendon become " ruptured by abrasion " upon the' 
roughened surface, or by an inflammatory softening— gelatina- 
tion — of the tendon, whereby its smooth, cartilaginous surface 
becomes roughened ; string-like processes of its fibres are seen 
upon it; which finally unite to vascular projections from the 
bone, and form a bond of union between the two. The pro- 
gress of caries is thus arrested by the adhesion of the tendon 
to the bone. 

The effect of caries is to remove the bony laminal layer 
and the cartilage, and thus destroy the articulation which it 
may invade; but whilst this process of destruction goes on 
within the bone and upon its extremity, we find that the peri- 
osteal surface and compact tissue become the seat of new bony 
deposit, situated beneath the periosteum, which envelops the 
diseased bone, as it were, in a ring, and extends to all the 
bones of an articulation which may be involved in the caries ; 
finally, binding them firmly together ; in fact, converting two or 
more bones into one, and destroying motion. The united bones 
now perform the functions of one bone ; and in virtue of this 
the pain produced by the attrition of the roughened surfaces 
of the bones one upon the other is no longer caused. 

Within the bone the degenerative process, in the majority of 
cases that have been carefully examined by me, is limited by 
consolidation of the cancelli ; and in a recent specimen which I 
have in my possession, I found that the first alteration to be 
observed, in addition to the increased vascularity, was the 
removal of the fatty material — which is found abundantly in 
bone during health — and the formation of an organizable lymph, 
which is finally converted into bone, giving to the original 
trabeculated structure an ivory-like appearance. 

The external signs of caries vary according to its seat. If it 
be in the bones of an articulation having a distensible capsular 
ligament, as the true hock, there wUl be swelling of the joint by 
distension of its synovial membrane and capsular ligament, with 
heat, pain, and lameness. But if it be limited to the mere gliding 
articidations, their synovial membranes are too limited to allow 
of this distension; and before the appearance of the external 
subperiosteal deposition just referred to, the speciality of the 
lameness and heat of the part are the only signs. 



168 DISEASES OF THE BONES AND ARTICULATIONS. 

, Treatment. — ^When caries is firmly established, the only 
method by which it can be repaired is by assisting the process 
of adhesion between the opposing surfaces. This is to be effected 
by rest; and by the actual cautery, which has a wonderful 
effect in allaying the diseased action and removing the pain. It 
also promotes the formation of reparative material, and hastens 
the process of repair. It must be understood that when anchy- 
losis occurs in articulations with extensive motion, such as the 
true hock, elbow, &c., the animal is of little use, and no treat- 
ment is of any avail; biit- when caries is commencing in these 
situations, its progress may be arrested by rest and the cautery, 
or other severe external irritant. But when the mere gliding 
joints are its seat, then anchylosis may be looked upon as a 
radical cure. 

Necrosis, or death of a bone, corresponds to mortification of 
the soft structures, and is as distinct from caries as mortification 
is from ulceration. Necrosis is divided into four varieties, 
namely, 1st, the scrofulous ; 2d, the superficial, or that which in- 
volves the outer lamella, and presents itself in the flat and long 
bones ; 2>d, that form which destroys the internal part of a bone, 
and in which the outer shell is not affected ; and 4:th, that in 
which the whole thickness of the bone dies. The last three 
forms are respectively named external, " superficialis or partialis," 
central or internal, and general necrosis, or necrosis totalis. 

Necrosis superficialis depends upon very acute superficial 
Ostitis, periostitis, or any injury which destroys the periosteum, 
as well as injuring the bone itself. It was thought at one time 
that the mere removal of the periosteum was sufficient to pro- 
duce this form of necrosis, but it is now ascertained that such is 
not the csLse, and that when necrosis and exfoliation occur, they 
do so from the violence which separated the periosteum having 
destroyed the vitality of the bone itself. 

I am not aware that this form occurs except from direct 
violence to the part, such as blows, kicks, &c., which expose the 
surface of the bone, and excite inflammation in the adjoinino- 
tissues. The necrosed portion presents a white, waxy appear- 
ance, as if it had been carefully macerated, sonorous when struck 
by a probe, and if exposed to the atmosphere before separation, 
it becomes changed in colour, passing through various degrees of 
green, brown, and black. These changes are attributed to the- 



■ NECEOSIS. 169: 

action of the atmosphere and the character of the discharge. 
■The limits of the dead portion are not always easily defined, and 
at all times its outlines are very irregular. If the skin should 
be uncut, or he healed, over the seat of the injury, an abscess 
soon forms, which, if left alone, discharges itself; and if the 
ulcer is examined by a probe, the bone will be found bare, and 
perhaps loose. The abscess does not heal until the loose por- 
tion, called an exfoliation, is removed ; in fact, there is now a 
fistulous communication between the dead bone and the at- 
mosphere. The separation of the dead bone is effected by 
the absorption of the layer of living bone immediately con- 
tiguous to it, by a process analogous to sloughing of the soft 
parts. 

When the dead bone is removed — naturally or by surgical in- 
terference — the surface beneath it granulates, and bony matter 
is formed in the gap, which, however, is not always sufficient to 
fiU it, but to roupd off its edges, and the part is left permanently 
deficient. 

Tree vent must be given to the pns, which is curdy in con- 
sistence, and foetid in odour — the dead bone examined, and when 
found to be loose removed by the forceps. If the necrosed 
portion be a mere thin pellicle, the dilute hydrochloric acid 
will often dissolve it, and thus save a prolonged process of ex- 
fohation. 

This form of necrosis often attacks the inferior maxillary hone 
from the pressure of the curb, and the os pedis, from pressure 
of a foreign body, as the shoe nail. 

Necrosis totalis affects the shafts of the long bones, more 
especially the metacarpals and the metatarsals, and also the 
scapulae. One specimen of the latter is now in the Veterinary 
College Museum.— (See Photo-lithograph, Plate I., Pig. 6.) 
The cause of this form is violent concussion, as from galloping 
or jumping, producing violent ostitis, which from its rapidity 
does not permit the dense texture of the bone to open out, so 
as to allow the Haversian canals to accommodate the congested 
vessels, or permit them to relieve themselves sufficiently by 
effusion. In addition to this, the small amount of exudation 
which ensues blocks up the canaliculi and lacunae of the bone, 
arresting its nutrition, and finally destroying its vitality. 

When the vitality of the bone is destroyed, a large deposit 



170 



DISEASES OF THE BONES AND ARTICULATIONS. 



of osseous matter takes place under the periosteum, and in 
this manner the dead bone, which is 
called a sequestrum, becomes enclosed 
within a capsule, perforated by numer- 
ous openings termed cloaca; (see Fig 
25), and these are not filled up until 
the dead bone is entirely removed ; but, 
after this has taken place, granula- 
tions spring up from the inner surface of 
the shell, and the cavity is eventually 
filled up by osseous matter, so that in- 
stead of a hollow bone we find a solid 
cylinder. 

It may be here noticed that the bones 
of the legs of race-horses are more liable 
to necrosis than those of animals of a 
coarser breed, not only because they are 
subjected to greater concussion, but being 
more compact in their structure, inflam- 
mation in them is apt to terminate in 
their death. 

The separation of the sequestrum is de- 
scribed as follows by Eokitansky : — " All 
round the necrosed portion, that is to 
say, at its margins, and at the part where 
its surface is exposed to that of the healthy 
Fia. 25.— Necrosis totalis ^o^g ^jjg latter undergoes a gradual ex- 

of metatarsal bone, a, Se- . c ,- e -i^ i- i 

questral capsule. 6 and c, pansion or rarefaction of its tissue, by 
Cloacae, or foramina grandia. ^}^q enlargement of its Haversian canals, 
assumes a rosy colour, and becomes succulent. It gradually 
acquires an areolar structure, and is thus more rarefied ; 
at length it disappears altogether, and a red, soft, spongy 
substance, or layer of granulations, occupies its place. This 
change is produced by the inflammatory process, which gives rise 
to suppuration and gTanulation ; the bony tissue beginning with 
the Haversian canals is dissolved by the matter secreted within 
them; while the granulations which shoot forth at the same 
time fill up the enlarged canals. The immediate result of this 
process is the formation of a furrow of demarcation, which en- 
circles the margin of the dead bone, and is filled up with granula- 




NECROSIS. 



171 



tions ; and so far as the process is completed on that surface, of 
the living bone which faces the dead, so far is the sequestrum 
separated." The necrosed portion is very irregular in its outline, 
and the luxuriant granulations from the 
hving parts shoot into these irregularities, 
causing a dove-tailing closely resembling 
actual union. From various specimens 
in my possession, I find that the dead 
bone, when of any considerable magni- 
tude, is removed in numerous portions, 
that is to say, it becomes broken into 
several fragments, which find their way 
to the surface through the cloacae time 
after time. In the annexed illustra- 
tion five sequestra were found within the 
capsule. 

The cloacse, or foramina grandia, serv- 
ing as outlets for the pus and sequestra, 
present themselves about the middle or 
lower third of the new bone as oval- 
shaped openings ; and a remarkable fact 
has been pointed out by Professor Good- 
sir, connected with these, namely, that 
" they are almost invariably opposite to a 
smooth or unaltered surface of the dead 
shaft, and that they result from the pus, 
thrown out from the granulating internal 
surface of the new shaft, making its way 

, ,1 , . T, ,1 . . \_ I'lG- 26.— Section of the 

to the exterior, by the parts not yet tone represented in Fig. 25, 

closed, in consequence of having been showing five sequestra, or 

., ,. „ ,, 11 1. p. T.- 1 dead pieces of the original 

opposite portions of the old shaft, which bone, a, Capsule; 6 and c, 

had not afforded separate osseous centres." Sequestra. 
By this, Goodsir means that the smooth surface of that part of 
the old shaft had not afforded spiculse of bone adherent to the 
periosteum, when that membrane became separated from the 
old shaft, to act as centres of ossification ; for he founded the 
doctrine that the formation of new bone depended not so much 
on the periosteum, as upon the spiculse of living bone which 
were attached to it. He says : — " "When the entire shaft of a 
bone is attacked with violent inflammation, there is generally 




172 DISEASES OF THE BONES AND AETICULATIONS. 

time, before tlie death of the bone takes place, for the separa- 
tion of more or less numerous portions of its surface. When 
the entire periosteum has separated from the shaft, it carries 
with it minute portions of the surface of the bone. Each of 
these is covered on its external surface by the periosteum, on 
its internal by a layer of granulations, the result of the 
organized matter which originally iilled the Haversian canals ; 
the gradual enlargement and subsequent blending of which 
ultimately allowed their vascular contents to combine, with the 
layer of granulations just described, to form the separating 
medium between the dead shaft and its minute living remnants. 
These minute separated portions, after having advanced some- 
what in development, appear, when carelessly examined, particu- 
larly in dried specimens, to be situated in the substance of the 
periosteum, and have been adduced, by the advocates of the 
agency of that membrane in forming new bone, as evidences of 
the truth of their opinions.'' 

The causes of necrosis totalis are ostitis and periostitis of a 
violent form, brought about by galloping, jumping, or any other 
cause of violent concussion ; it is situated in the long bones, 
or in the os pedis in some cases of very acute laminitis, with 
sloughing ; and a partial or total necrosis of this bone sometimes 
results after neurotomy. 

The symptoms are violent pains, manifested by lameness, if 
in the extremities, with swelling, at first doughy and elastic, 
by reason of the effusion between the periosteum and bone, 
and of the thickening of the periosteum itself; it presents no 
distinct boundary when involving the whole length of the shaft, 
The swelling gradually becomes harder as the process of ossifi- 
cation goes on ; but at various parts, more especially towards 
the lower portion of the bone, soft points can be detected in it, 
attended eventually by fluctuation. These finally burst, and 
discharge pus, which may at first be odourless ; but after the 
abscesses have been open a short time, it emits that peculiar 
foetor characteristic of diseased or dead bone. If the abscesses 
be examined with the probe, the bone wiQ be found bare, and 
perhaps loose. 

Treatment. — If a considerable length of a shaft is dead, some 
time must be allowed for the consolidaticin of the capsule before 
any attempt is made for the removal of the sequestrum, taking 



NECROSIS. 173 

care that the animal is properly cared for, hy having good food, 
comfort, and cleanliness ; but if the bone be not a weight-bearing 
one, as the inferior maxilla, no time should be lost in removing 
all portions of the dead bone. Tlie following case wiH illustrate 
the necessary treatment. 

A bay mare was brought to the College last winter with a 
fistulous opening in the lower jaw, from which iiowed a large 
quantity of very foetid pus. Upon examination, about five 
inches of the original bone; extending from the incisors back- 
wards, was found enclosed in a capsule of new bone, in which 
were several cloacae connected with the fistula. When the 
probe was introduced, loose pieces of bone could be detected 
within the capsule. The animal was cast, the skin dissected. 
from the largest fistula, and the cloacae enlarged with the tre^ 
phine. It was found necessary to make two openings in the 
capsule, before the sequestrse could be removed by the forceps ; 
the parts were now washed out by syringing with dilute carbolic 
acid (the foetor being very offensive), and the animal allowed to 
rise. Three days afterwards the discharge had entirely ceased ; 
the wound healed up rapidly, and the mare continues well to 
this day. 

The same principle of treatment will apply to necrosis, wher- 
ever situated, care always being taken that every portion is 
removed, and that strong and proper instruments are used. 
The symptoms of partial necrosis of the os pedis will be exactly 
like those of partial fracture of it (described hereafter); and 
the symptoms of total necrosis in acute laminitis will be swell- 
ing round the coronet, with great lameness, separation of the 
crust from the sensitive foot, discharge of a dark-coloured, 
sanious matter from the upper part of the foot, and finally, if 
the animal live, sloughing of the whole hoof, accompanied by 
great constitutional excitement and irritative fever ; the pulse, 
at first hard, full, and rapid, finally becomes small, thready, and 
quick ; with foetor of the breath in some cases, and death in a 
very short space of time. The foetor of the breath and the very 
rapid sinking are supposed to be caused by absorption of the 



sanious discharge. 



I think I need scarcely remind the reader that in compound 
fractures, when the fragments are completely detached and 
separated from the^ bone, they die, constituting necrosis by 



174 DISEASES OF THE BONES AND ARTICULATIONS. 

fracture ; that in all cases their presence is made manifest by 
the formation of fistulous abscesses ; and that their removal is 
imperative. 

In the ox tribe, the digital bones suffer from necrosis, owing 
to an inflammation of the inter-digital fibrous tissue. 

It was supposed at one time that a seq[uestrum was reduced in 
size by the action of the absorbents ; but it is now placed beyond 
all doubt that dead bone is in every respect a foreign body, and 
cannot be acted upon by the absorbents more than any other 
insoluble substance. But at the same time it must be admitted 
that a sequestrum is much smaller than the original bone ; this 
can only be accounted for by the fact that its animal basis is 
dissolved by the purulent discharge, and that it is thus rendered 
brittle, and liable to be broken into fragments by the movements 
of the animal. 

Internal necrosis is very rare in the lower animals, one speci- 
men only in the Museum presenting any appearance of it. The 
following are its symptoms in the human being, namely, most 
excruciating pains, supposed to arise from the resistance of the 
outer shell to the swelling of the inflamed part. The fever is 
often so high as to prevent the patient obtaining repose. The 
enlargement, exceedingly hard and diffuse, depends on the swollen 
condition of the bone, and in time becomes very vascular and 
softened. The medullary membrane is completely destroyed. 
The swelling continues for a long time, but abscesses gradually 
form in the soft parts ; the outer layer of the old bone expands 
and grows, during the continuance of the siippuration, by the 
dilation of the Haversian canals; whilst new bone is formed 
externally, so that the sequestra! capsule is partly of old bone 
and partly of new. When the sequestrum is removed, and the 
process of regeneration complete, the bone consists from without 
inwards of the outer shell of new bone, the layer of old bone 
which is not necrosed, and the central portion of new bone 
formed by the granulations within, and which for a long time 
occupies the place of the medullary canal. 

The interior of the bone, at first solid, becomes opened up by 
the gradual enlargement of the Haversian canals of the new 
bone, whereby its structure becomes cellular, and in this way it 
incompletely supplies the place of the medullary canaL 

Many experiments have been made which show that the 



NECROSIS. 175 

destruction of the medulla is sufficient to cause the death of a 
bone, and it has also been carefully noted that the power of 
reproduction varies in the different bones of the body, being 
great in some, and less in others, and in some absent altogether. 
Thus the long bones, the lower jaw, and scapula possess the 
power of reproduction to a great extent ; the cuboid and other 
short bones cannot be reproduced. 

Portions of the cranium, under particular circumstances, says 
Pirrie, may to a certain extent be reproduced; but if both 
tables be destroyed, together with the pericranium, there will 
be very slight reproduction ; for the dura mater has very little 
tendency to produce new bone, and for this reason reproduction 
does not take place after the operation of trephining the skull. 
The bones of the face, however, seem to have the property, for 
in several instances I have witnessed complete reproduction after 
trephining the maxillary sinuses. 



SUBPERIOSTEAL SUPPURATION. 

Suppuration beneath the periosteum is not uncommon, and 
may result from blows, such as " speedy-cut," or from such opera- 
tions as " punching " for bone-spavin. The symptoms of this 
form of suppuration are, diffuse swelling, extending in every 
direction from the seat of injury. The swelling is tense and 
drum-like when felt ; it may be large, whilst it contains 
but little pus ; after a time, however, abscesses form on various 
parts of it, and discharge a foetid pus. The animal is very 
lame, and a high state of irritative fever supervenes, which 
may run on to a fatal termination. The treatment for cases of 
subperiosteal suppuration must be prompt, and should consist 
in making free incisions through the periosteum, and thus give 
vent to the pus. 

Punctured wounds, more especially in the neighbourhood of 
the elbow-joint, are very apt to be complicated by a collection 
of pus under the periostum, which, if not allowed to escape by 
free incision, is apt to burrow upwards into the articulation, 
thus causing that dreaded complication, open joint. I have 
seen wounds that were several inches from the articulation 
terminate in this way. 



176' 



DISEASES OF THE BONES AND ARTICULATIONS. 



ABSCESS IN THE SUBSTANCE OE A BONE. 

The formation of abscess in the substance of a bone is of rare 
occurrence, and I have only witnessed one marlced case of it. 
The bone is now in my possession, and the two figures represent 
its external and internal appearances. 





Fig 27. 



Fig. 28. 



Fie. 27. — External view of hnmenis of a horse, with central abscess. 

Fig. 28. — Internal view of same bone. At a is a weE-defined abscess, 
containing inspissated pus ; 6 shows the dilated condition of the medul- 
lary canal, the cavity being originally filled with pus. 

An abscess may form within the cancellated structure, which 
is hollowed out, as in the illustration, and is generally situated 
near the articular extremity of a long bone. The same amount 
of inflammation necessary to produce pus in the cancelli, would, 
if situated in the compact tissue, cause necrosis. It is accom- 
panied by thickening of the outer shell of the bone, as in 
necrosis. The diagnosis of internal abscess will be very diffi- 
cult, on account of the depth of its seat. -The enlarged bone, 
with pain, will be our only guides until the pus has pierced 



ABSCESS IN BONES. 177 

the bone, and found its way to the surface of the skin. 
In long-continued cases of lameness, with enlargement of a 
bone, as in the specimen, the practitioner should open the 
enlarged portion by the trephine, the probabilities being that 
he wlU find either pus, or a sequestrum, or both, imprisoned, 
and that their removal will bring on a favourable termina- 
tion. In the case from which the specimen was obtained, no 
other reason could be given for the abscess than that the pole 
of the carriage, by continually striking this part, brought on 
inflammation and suppuration of the medullary membrane, as 
weU as periostitis. 

When the trephine has to be used, it is nearly always neces- 
sary to cast the patient ; making a careful incision on to the 
diseased bone ; avoiding injury to important blood-vessels and 
nerves; dividing the muscular structures in the direction of 
their long axes ; separating all the soft tissues from the bone 
before the trephine is applied, or its teeth will become clogged ; 
and, finally, washing out the abscess thoroughly with water in 
which a small quantity of the pure carboho acid has been dis- 
solved ; and leaving the lower portion of the wound in the soft 
structures open, to allow the escape of the discharges. 

Mr. Stanley says that "circumscribed abscess is, in some 
cases, attributable to the softening of tubercular matter, analo- 
gous to a pulmonary vomica, and that the contents may be 
discharged, leaving a cavity resembling a tuberculous cavity in 
the lungs." The circumscribed abscess, according to the same 
writer, " usually remains of a small size, but in some cases it 
has enlarged much beyond the natural limits of the bone. 
Such an enlargement is not the effect of a simple expansion 
of the waUs of the bone ; for in some of these cases the osseous 
walls of the abscess have increased in thickness, with enlarge- 
ment of the cavity. The process consists of the combined 
action of absorption on the inside of the abscess, and of osseous 
deposit on its outside, whereby its osseous walls may acquire 
any degree of thickness, according to the predominance ot 
absorption in the one direction, or of deposit in the other." 



CHAPTER X. 

NON-INFLAMMATORY DISEASES OP BONES. 

EICKETS — MOLLITIES OSSIUM OSTBO-POROSIS FRAGILITUS OSSIUM- 

OSTEO-SARCOMA — EFFECTS OF MERCURIAL POISOMING ON BONES. 



EICKETS. 

The terms " rickets '' and " rachitis " are used to denote an 
unnatural softness of the osseous system in young animals, 
and is referable to disordered nutrition of the osseous tissue;* 
in fact, to the mal-assimilation and non- development of the 

materials neces- 
sary to the forma- 
tion of bone. 

Rickets may be 
witnessed in foals, 
calves, and young 
dogs, more especi- 
allyyoungspaniels 
and pointers. In 
foals and calves the 
metacarpal bones 
are those which 
soonest bend; in 
dogs, the lower 
third of the hume- 
rus ; giving to the 
dog a dwarf-like 




appearance : 
stands with 



he 
his 



Fig. 29. 

fore legs wide apart, and walks M'ith a peculiar rolling gait, 
throwing the weight of his body from one limb to another in 



KICKETS. 



179 



a peculiarlj"- ludicrous manner, the sternum almost touchins? the 
ground. In foals and calves, the shafts of the metacarpals are 
the first to give way, the curvatures being from within out- 
wards; thus the knees are thrown outwards, and the toes 
drawn inwards. The articulations and extremities of the hones 
sometimes become enlarged, hot, and painful ; causing so much 
lameness that the little 
animal merely touches the 
ground with the toes of the 
affected limbs, and as the 
animal increases in size the 
spinal column becomes too 
feeble to bear the weight 
of the body, and symptoms 
of paralysis are observable. 

When the bones of the 
posterior extremities are 
affected, the toes are turned 
outwards, the hocks in- 
wards: the points of the 
calci almost touching each 
other; the animal being 
what is termed "cow- 
hocked," the metatarsals 
at their middle being 
bent inwards and rather 
backwards. In the, dog the humeri — the bones most commonly 
involved — are bent laterally by the action of the muscles, their 
inferior extremities being pulled upwards and outwards as in 
specimens 29 and 30, and the lower third of the shafts curved 
inwards, the curvatures being so great as almost to bend the 
bones completely upon themselves. 

In rickets, not only is there a deficiency of the inorganic 
elements of the bones originally — namely, the phosphate and 
carbonate of lime — but there is a want of power to assimilate 
these salts; for during the progress of the disease there is 
inordinate excrebion of them from the system, as shown by 
deposits in the urine. The structure of the bones is soft, 
cartilaginoTis, and open ; but if the animal be allowed to 




FrGS. 29 and 30 illustrate the bent condition 
of the humerus in rickety dogs. 



180 NON-INFLAMMATOKY DISEASES OF BONES. 

live, earthy matter is deposited in the bones, which eventually 
become firm ; the curvatures, however, remain. It is a notice- 
able fact that the centre of the curve in a rickety bone becomes 
strengthened by a deposition of additional bony matter ; thus 
we always see that a horse with bent legs has depositions in 
the very centre of the arch, strengthening thd weakest part, and 
making the bones bulkier than natural. 

In hydrocephalus the rickety condition of the bones is the 
result of the pressure of the cranial iiuid. 

Eickets appears when the patient is a few weeks or months 
old, and is .caused by constitutional debility, the scrofulous 
diathesis, or by external and preventible causes. Thus we find 
it in calves which are not allowed to suckle their mothers ; in 
foals, when the mothers are taken to work during the day, and 
their offspring allowed to suckle perhaps every morning and 
night, or at most three times a day. Young animals fed upon 
artificial foods in lieu of milk, and kept without exercise, or 
when placed under any condition which interferes with those 
natural functions peculiar to youth, may become rickety. 

In all cases there is a tendency to irregularity in the bowels, 
the milk passing through them in an ill-digested, curdy condi- 
tion, white in colour and souf in odour, " the white skit," as it 
is vulgarly called. In a high-bred calf that I once observed, 
this kind of purging had existed for several weeks. At the 
time I saw him he was about three months old ; had remained 
healthy until he was six weeks old, at which time he manifested 
symptoms of rickets ; and when examined by me was found to 
have bending of the bones of the extremities, enlargement of the 
cranium, with separation of the bones at their sutures, and that 
he was blind from the pressure of the fluid contained within the 
cranial cavity. 

The treatment of rickets must be directed to the removal of 
all influences deleterious to the constitution ; and to the support 
of the weak and bent limbs. To fulfil the first purpose, the most 
appropriate remedies are dry and pure air ; a large, roomy, loose 
box, or, if the weather be warm and dry, a nice field or paddock, 
and the constant companionship of the mother. If the patient 
be a calf which has not been allowed to suckle from its birth, 



EICICETS. 181 

great care must be taken that it be fed repeatedly, tliougli mode- 
ratelj, during the day. 

The constitutional treatment must be directed to the con- 
dition of the digestive apparatus. A very gentle aperient 
might at first be given with advantage, such as four ounces of 
castor oil — or a dose corresponding to the age of the patient — 
made into an emulsion, with two drachms of the bicarbonate of 
potash or soda, and a sufficiency of water. This should be 
succeeded by small quantities of lime-water, say half a pint, 
two or three times a day, in the same quantity of milk ; and 
when the acid condition of the bowels has passed away, which 
will be indicated by absence of the sour or acid smell and 
better colour of the faeces, the preparations of iron will be found 
of great service, more especially the syrup of the phosphates, 
great care being taken that the digestive organs are not again 
thrown out of order. As a rule, the mother possesses an abun- 
dant quantity of milli ; but should it be otherwise, the patient's 
food must be made sufficient for its wants by an additional 
supply of milk or of linseed tea, — a very good substitute, and 
often a desirable variety. Cod-liver oil may be given with 
advantage ; and if the animal be valuable, the expense will be 
amply repaid by a successful issue. 

The curvatures in the limbs are to be supported by slight 
but firm spHnts of wood, applied to the concave aspect of the 
curves, taking care that they are of sufficient length to reach 
the unbent portions of the limbs, both above and below the 
curves. A moderately firm bandage round both splint and leg 
will cause the latter to approach the straight line, the bones 
at this age being elastic and pliable. The splints must be so 
padded as not to bruise the prominent parts of the legs, and 
when properly and skilfully applied, may remain on for some 
weeks. If there be much pain and lameness, fomentations and 
frictions must be repeatedly made use of, and the splints removed 
from time to time. 

The pathological anatomy of rachitis is thus given by 
Eokitansky:— "The texture of the bones is affected in two 
ways, of which sometimes one predominates, sometimes the 
other. In the first case the bone is rarefied and increased in 
size— expanded, in fact. A pale yeUowish-red jelly is effused 
into its enlarged canals and cells, into the medullary cavities, 



182 NON-INFLAMMATOEY DISEASES OF BONES. 

and even under the periosteum. The bone itself is abundantly 
supplied with vessels, and full of blood, and its colour is there- 
fore darker than is natural, and red. Occasionally this change 
reaches to such a degree that the cells of the spongy bones, 
and those in the interior of the medullary tubes, become ex- 
cessively distended, and, as their walls disappear, are merged 
into larger cavities ; several cavities become single spacious 
chambers, and the bones uncommonly soft and fragile. In the 
second case the bone is, in addition, deprived of more or less 
of its mineral constituents; and sometimes it is completely 
reduced to its cartilaginous element, and appears like a bone 
that has been steeped in acid. The bony corpuscles are empty, 
and their rays have disappeared ; and when this is the case, the 
lamellar structure is here and there obliterated. At other parts 
the lamellse appear, as it were, to have fallen asunder, and the 
corpuscles are seen quite distinctly interspersed between them. 
It is upon this condition that the flexibility of rickety bones 
depends." " It is remarkable," says Eokitansky, " that in cases of 
general rickets the reduction of a bone to its cartilaginous 
element so preponderates in some bones as to go on, even to 
completion, without any trace of rarefaction." 

The late Professor Barlow taught that in rickets the car- 
tilage yielded neither chondrine nor gelatine. This theory 
was based upon one given in Simon's Animal Chemistry. 
However, it is now ascertained that the analysed bones were 
not rickety, but affected by mollities ossium. 

To conclude the subject of rickets, I must say that the 
swelling of the articulations seems to indicate that the disease 
does not consist in simple absence of the due quantity of 
phosphate of lime, and analysis has proved that the cartilage 
itself is altered in its constitution, the fat increased, and the 
fluoride of calcium, present in healthy bone, is absent in rickets. 
Analyses of some rickety bones give — animal matter 81"] 2, 
earthy matter 18'88 in 100 parts; against animal matter 31'10, 
earthy matter 68'90 in healthy bones. 

Allied to rickets is what I may describe as true atrophy of 
the bones, or 

MOLLITIES OSSIUM, 

A remarkable case of which I have had the opportunity 



MOLLITIES OSSIUM. 183 

of seeing, and in which there was removalof the earthy- 
constituents of the cranial and facial hones, more especially 
at their borders, without any visible external alteration of 
structure. There was neither swelling nor abscesses; in 
fact, nothing to indicate the pathological change. In this 
case examination after death revealed softening, thinning, and 
perforation at the sutures and in the bodies of the bones, giving 
them a pitted and worm-eaten appearance. The perforations 
were fiUed, upon the cranium, by the pericranium and dura 
mater, which were adherent to one another. The palatine bones 
and alveolar processes were soft, porous, and spongy. — (See 
Photo-lithograph, Plate I., Fig. 8.) An examination of the 
plate wUl show that the borders of the various bones are 
separated, in some places, to the extent of nearly half an inch. 
The ethmoidal bone was completely absorbed, and the brain lodged 
in the frontal sinuses, filling them, as well as its proper cavity. 

The case is so interesting, instructive, and unique, that I 
cannot do better than describe it. The patient was a grey 
Clydesdale gelding, nine years old. He had always been in 
good health until within about three months of the time when 
I saw him. At this time he was suffering from the effects 
of delirium — the third attack within three months — and now, 
having a discharge from the nostril, was supposed to be glandered. 
I foimd him blind (amaurotic), but not quite unconscious ; was 
very somnolent, or semi-comatose ; but would wake up with a 
frightened start when anything disturbed him. He was in fair 
condition; the nasal discharge was of the nature of a thin 
reddish serosity, and more abundant from one nostril than from 
the other. He was unable to masticate hay and corn, or did so 
very imperfectly, and was becoming worse in this respect. His 
powers of deglutition were also imperfect, and on examination 
I found the teeth were loose, and that he could not close his 
mouth firmly ; but the lips were not pendulous. Upon inquiry, 
I found that he had been supported by thick gruel, oatmeal 
balls forced into his mouth, bread and milk, boiled potatoes, &c. 
In fact, being a great favourite, he had been well taken care of. 

Being anxious to know the source of the nasal discharge, 
about which my opinion was sought by the attending prac- 
titioner, I explored the facial sinuses by means of a gimleti 
and discovered that the bones were soft, thin, and easily perfo- 
rated, and that the sinuses were not filled with the red serosity 



184 NON-INFLAMMATOKT DISEASES OF BONES. 

above mentioned. Externally, there was nothing to denote 
this alteration in the bones, and the only observable change of 
structure was wasting of the masseter muscles, and, as a con- 
sequence, an apparent undue prominence of the zygomatic 
ridge. My prognosis was unfavourable, and in a few days 
afterwards he died comatose. On making an examination, the 
brain was found very white, and greatly enlarged, the enlarge- 
ment partaking of the character of a fibrous development ; the 
dura mater was much thickened, in some places upwards of 
an inch in thickness. The lateral ventricles wore nearly 
obliterated by growth of fibrous tissue in the brain substance. 
The cranial nerves, with the exception of the fifth pair, were 
normal in appearance; but this (the fifth) pair were greatly 
enlarged, not only in their general bulk, but in each of their 
fibres, which were coarse, stringy, and distinctly separated by 
an abundance of fibrous tissue. As already stated, the eth- 
moidal bone was absorbed, and the brain and thickened dura 
mater filled the frontal sinuses. 

How can this strange disease be accounted for ? If the 
patient had been human, syphilis or mercury would have been 
blamed; but here was a patient that had never been mer- 
curialized, never syphilitic. It might with reason be said that 
the attack of phrenitis had led to the brain enlargement, and 
that the absorption of the cranial bones had resulted from 
internal pressure from the growth of the cerebral mass. But 
how about the facial bones ? "Was the altered structure of the 
fifth pair of nerves sufficient to account for this ? My colleague, 
Dr. Young, is of opinion that the disease was primarily in the 
bones, and that the pathological alterations found in the brain 
and nerves were a result of the osseous change. 



OSTEO-POEOSIS. 

This disease was first described in this country by Professor 
VameU, in the Veterinarian of 1860. It appears from his 
careful and elaborate report that at one farm near Eeading, 
no fewer than six horses had been affected with this strange 
malady when he reported upon it. Since then, however, many 
practitioners have witnessed it, and all agree that Mr. Varnell's 
report is a most faithful one. Mr. Anderson of Glasgow, and 



OSTEO-POROSIS. 



185 



Mr. Eobinson of Greenock; have seen it frequently ; and I am 
indebted to them for many valuable hints upon the peculiarity 
of the symptoms, and for specimens of the bones of the head 



sufferins? from the disease 




Fig. 31. 



Fig. 32. 



Figs. 31 and 32. — Cranio-faoial bones affected with osteo-porosis ; the 
front view, Fig. 31, representing the enlarged condition of the face ; and 
Fig. 32 showing the disease extended into the alveolar cavities. 

As a rule, the bones of the face are the first to suffer ; but 
this is liable to exceptions, as the following extracts from the 
Veterinarian of 1860 will show. The symptoms were de- 
scribed to Mr. Varnell by a Mr. "Wallin : — " My attention," says 
Mr. "Wallin, " was in most instances first directed to defective 
action, perhaps in one joint or limb only, in which, upon exami- 



186 NON-INFLAMMATOEY DISEASES OE BONES. 

nation, tenderness would be evinced, with inordinate heat, and 
in a few days visible erdargement would be observed to exist. 
In the course of a week, or thereabouts, another of the limbs 
would become affected in the same way, when the acute symp- 
toms of the first attacked would perhaps have partially passed 
off. In this way aU the four extremities, one after the other, 
eventually became diseased. The appetite was generally good, 
and for a time the animals did not lose flesh very fast ; but after 
a while, from the great constitutional disturbance set up, they 
feU off in their appetites, and began to waste very rapidly. The 
pulse seldom rose much above the natural standard, and the 
excretions appeared to be natural." 

It appears that these horses had been, all but one, bred on the 
same farm, and were the offspring of different mares and different 
sires. The facts gained by Professor VarneU are very interest- 
ing, and may be briefly stated as follows : — 

They had been fed on the same food as other horses on the 
farm which had never shown any symptoms of the disease. 
The owner had been in the habit of feeding his horses in the 
same way for years without any previous ill effects. Bran or 
pollard, along with the ordinary produce of the farm, formed 
the greater part of their diet. They all drank the same kind 
of water as the other stock. Professor VarneU examined the 
food they were getting, and pronounced it good. It appears 
that male animals only were attacked ; none of the fillies had 
ever been affected with the disease. Another fact that Professor 
VarneU mentions is most interesting, namely, that the gentleman 
had another farm a short distance only from when the disease 
existed. On that farm not a single instance occurred, although 
the horses were bred from the same parents, and partook of the 
same kind of food. I wiU detail the symptoms in the two 
animals that were suffering at the time of his visit in Professor 
Varnell's own words. He says : — " I was first shown a brown 
eart-horse, five years old. He was standing in the cart-horse 
stable with other horses ; was in very fair condition, and at first 
sight appeared as if nothing were the matter with him; the 
pulse was only a little above the ordinary standard, and the 
tjxcretions, as far as I could see or learn, were natural. I 
ordered him to be led out of the stable, when I observed that 
lie stepped short, flexed his limbs with difficulty, and apparently 



OSTEO-POEOSIS. 187 

with mucli pain, particularly the near fore and the off hind legs, 
the knee and hock joints of which were hotter than natural, 
slightly swollen, and tender when pressed upon. These symp- 
toms were also present in the other two limbs, hut in a much 
less degree of intensity. On causing the horse to be turned 
round, or moved in a backward direction, a decidedly rigid state 
of the loins M'as observed, and by pressing upon any part of the 
back considerable pain was evinced. On examining the animal's 
head, I was particularly struck with the enlarged and roundish 
appearance of the facial region. Each ramus of the lower jaw^ 
the upper maxillary, and the nasal bones were evidently en- 
larged, and pressure on them caused some amount of pain. On 
looking into the mouth, I observed that the mucous membrane 
was of a purplish tint, except at the margin of the gums, where 
it was of a pinkish colour, crossed here and there by bluish 
lines (veins). The lining membrane of the nasal passages and 
the conjunctival membrane also were paler than natural. This 
condition of the membranes, I was assured by Mr. Wallin, could 
not have been caused by any medicine that had been given." 

In the other case, a chesnut horse, which Professor Varnell 
examined, the joints were swollen, hot, and tender ; there was the 
same rigidity of the back, and the peculiar colour of the mucous 
membranes; but the enlargement of the bones did not exist. 
This case had been iU for about six months. 

The post mortem examination revealed the following condition 
of parts : — The internal organs, with the exception of a peculiar 
paUor, showed no marks of disease. The chesnut horse was sent 
to London, and on his arrival at Paddington Station he was 
found unable to walk from the horse-box to the van that was 
sent to take him to the Eoyal Veterinary College. On his 
attempting to walk, his fore legs gave way at the elbow-joint on 
one side, and the shoulder-joint on the other, in consequence of 
the articular and capsular ligaments, and the tendons of the 
muscles, which are attached near to these joints, becoming 
detached (as was found to be the case afterwards) from their 
bony connections, by the tearing away of portions of diseased 
bones. The horse was destroyed upon the spot, and the carcase 
taken to the College for dissection. "The soft parts," says 
Professor Varnell, " generally were paler than is natural, especi- 
ally the muscles of those limbs which had been thrown out of 



188 NON-INFLAMMATOEY DISEASES OF BONES. 

use from the pain produced wlienever any movement was at- 
tempted to be made. But in these structures I did not detect 
the slightest traces of fatty degeneration. The fat generally had 
a mottled, watery appearance, which is very common in animals 
that are rapidly losing flesh, and this had been the case in a very 
marked degree for a short time before the horse was destroyed. 
In disarticulating the limbs from the trunk, and also the several 
bones of each limb one from the other, the appearance of the 
interior of each joint was remarkable. In most instances, 
altliough not in all, the articular cartilage was of a dark slate 
colour, much thinner than is natural, and in many places it was 
entirely lost. This was especially the case round the margin of 
the articulations, leaving the bone at that part quite exposed. 
The synovial membrane was considerably thickened, especially 
in tliose parts where it is most vascular. The quantity of 
synovia in each joint was small, of a dark colour, and in some 
cases mixed with blood. The character of some of the articu- 
lating surfaces, however, was quite different. In such, the arti- 
cular cartilage was pale-coloured, and in some places of a 
palish yellow, velvety to the feel, and evidently containing fat ; 
thereby indicating that the cartilage ceUs had disappeared, and 
fat had become deposited in their place. The ends of the bones 
were so much softened, that by applying a slight degree of force 
to the capsular or articular ligaments, small portions of the bone 
could easily be detached. The periosteal covering of the flat 
and irregular, and also some parts of the long bones, was very 
vascular, and could easUy be stripped off. The bones generally 
were likewise so very soft that they could be cut with a knife 
in any direction with the greatest ease; and if pressure were 
applied to the cut surfaces, or where the periosteum had been 
removed, blood would ooze from numerous points. In the 
interior of the bones the cancelli were filled with a red gelatin- 
ous substance. The ribs, the vertebrae, and indeed aU the irre- 
gular and flat bones, were in the same condition. The shafts of 
the long bones of the extremities were not visibly increased in 
size, nor was the shell or compact structure much altered. The 
ends of these bones, however, were enlarged and soft ; and on 
making a section through them, in their long diameter, the 
medullary canal, and especially the cancelli near to the extremi- 
ties, had a singular, although not a uniform, appearance. In 



OSTEO-POKOSIS. 189 

some of them, the whole of the interior was of a dark red colour, 
from congestion of the vessels and effusion of Wood into the 
areolar interspaces ; in others, one-half only of the interior was 
in this state, the other part being filled with a peculiar fat, and 
consequently very pale in colour. It was at the end of the bone 
affected in this way that the articular cartilage was of a palish 
yellow colour, velvety to the feel, and also slightly greasy. Even 
the teeth did not escape the malady, one of their constituents 
being evidently affected, which was evinced by the crusta petrosa 
being much thicker and more spongy than natural." 

The pathological anatomy of the bones was investigated by 
Dr. G. Harley, and communicated to Professor Varnell in a 
letter, dated 21st March I860:— "The horse's bones which 
I examined for you presented two well-marked varieties of 
morbid change, one of which was most characteristically seen 
in the bones of the head, the other in the long bones of the 
extremities. 

" 1st. As regards those of the head. The disease, although 
it affected all the bones, was most advanced in the lower jaw. 
I shall therefore limit my remarks to a description of it. The 
bone was considerably hypertrophied in its tranverse diameter ; 
the periosteum readily detached; the osseous tissue was of a 
pink colour, and on pressure a quantity of blood oozed from its 
surface, as if from a sponge. The osseous tissue was elastic to 
the touch, and so soft that it could with facility be cut with a 
knife. The surface of the section had a somewhat fleshy appear- 
ance, but to the nail it conveyed rather the impression of carti- 
lage. When examined microscopically the osseous tissue was 
seen to be expanded into a network of fine fibres. The Haver- 
sian canals, on the other hand, have become so enlarged that at 
first sight they might be mistaken for bony tissue, and the bony 
tissue mistaken for the Haversian canals. On examination with 
a higher power, not only is the osseous tissue seen to be rarefied, 
but the canaliculi proceeding from the lacunte or bone corpuscles, 
ns they were formerly called, are in many cases obliterated. The 
lacunae themselves are also not so distinct as in healthy bone. 
The enlarged Haversian spaces are filled with a gelatinous 
matter, mingled with a small portion of fat, and here and there 
pervaded with fine, scarcely visible fibres. 

" 2d. Long Bones of the Extre'^ities. — The periosteum, although 



190 NON-INFLAMMATOEY DISEASES OF BONES. 

readily detached, does not come away with so much facility as 
from the bones of the head, except towards the ends of the bones, 
where, strange to say, the ligaments had become detached by the 
mere movements of the animal during life. The outer surface of 
the shaft of the bone is firm enough, but on section it is found 
to be greatly thinned, in consequence of an enlargement of the 
medullary canal having taken place at the expense of the osseous 
structure. 

" The dilatation of the medullary cavity is most marked 
towards the extremities of the bone, and there the marrow is 
deeply tinged with blood. The osseous tissue, which in some 
parts is reduced to one-half, or even one-third of its normal 
thickness, does not present the spongy appearance of the cranial 
bones, but, on the contrary, is dense, and so hard that it cannot 
be cut with a knife. 

" After the calcareous matter is removed by acid, the section 
of the animal matter has a somewhat glistening cartilaginous 
appearance, here and there dotted with opaque white spots. 
Under the microscope, a thin section reveals a curious condition 
of things ; the Haversian canals, as well as the concentric bony 
lameUse surroimding them, appear perfectly normal. The lacunae 
and canaliculi, as far as can be ascertained in the decalcified 
bone, are equally healthy ; but, on close inspection, the opaque 
white spots observed by the naked eye are seen to be irregu- 
larly shaped cavities in the osseous tissue, filled with fat cells. 
These cavities vary in size, from that of a pin's point to a miUet- 
seed. They are not limited to any particular portion of the 
osseous structure, although they seem to have commenced, for 
the most part, in the lacunae. Some, however, may, with equal 
truth, be said to have originated in the Haversian canals, the 
walls of which have been gradually broken down and eaten 
away, as the morbid condition advanced ; the place of the 
earthy and animal matter being gradually taken up by fat 
corpuscles." 

Professor Varnell says, in continuation of his most admirable 
description, that " the bones, after being macerated and dried, 
exhibited many peculiarities which were not apparent in their 
fresh state ; for instance, the ulceration of the articular surfaces, 
which seemed to be altogether confined to the cartilages of 
incrustation, was found on their removal to affect the bone 



OSTEO-POliOSIS. 191 

beneath ; and the loss of structtire, however small it might be 
in the cartilage, extended more or less deeply into the bone ; 
the size of the cavity increasing with its depth. This fact, I 
think, proves beyond disputation that the loss of the cartilage 
depended primarily upon the diseased condition of the bone, 
and that the general thinning of the cartilage arose from the 
same cause. Scarcely an articulation of the whole body was 
free from this ' worm-eaten' condition of both bone and cartilage. 

" It was found likewise, in cleaning the bones after macera- 
tion, that, from their extreme softness, great care was necessary to 
prevent their different processes (epiphyses) from being detached, 
and the application of the slightest force to a portion of ligament 
or tendon, that was not sufficiently separated by decomposition, 
would be certain to effect their removal. 

" The external surfaces also of the bones, as contrasted with 
those in a normal condition, had a very singular aspect, especially 
in the flat and irregular bones. The ends of the long bones were 
similarly affected, but the shafts of most of them deviated but 
little in external appearance from a healthy state. A trans- 
verse section, however, of the middle of the shaft showed very 
distinctly that the osseous laminae surrounding the Haversian 
canals were very much thinner than is natural, thus necessarily 
leading to a considerable enlargement of the latter. In the first- 
named, however, and in the flat bones, instead of the surface 
being smooth and dense, it had a character not very unlike a 
fine sponge. The foramina for the passage of the blood-vessels, 
and especially those belonging to the periosteal membrane, were 
much dilated, thus giving the bone a kind of honeycomb appear- 
ance." (Figs. 30 and 31 illustrate this peculiar appearance very 
well.) 

It is found that the weight of the bones is much diminished 
in osteo-porosis. The articular surfaces undergo changes that 
are peculiar; thus, in Professor VarneU's cases, the articular 
cartilage upon one end of the femur was much thinner than 
is natural, of a dark slate colour in some places, and alto- 
gether lost in others ; the bone beneath it being very soft, and 
almost black from congestion of its vessels and extravasation 
of blood into its interstices. On the other end of the bone, the 
cartilage was in a different condition, pale in colour, and in 
some places of a yellowish hue, soft and velvety to the touch. 



192 NON-INFLAMMATORY DISEASES OF BONES. 

aud containing a small quantity of fat. Beneath the cartilage 
the bone was found soft, the lamellae very thin, with the inter- 
spaces filled with a greasy white-looking substance, fat, and the 
extremity of the bone generally non-vascular. The synovial 
membrane was much thickened in some joints, but the quantity 
of synovia in all was small, dark in colour, and in some cases 
mixed with clots of blood. The periosteum of aU the bones 
was easily stripped off, and the bones themselves were soft 
and easily cut with the knife. Within the bones the cancelli 
were filled with a red gelatinous substance. The ribs, the 
vertebrae, and aU the irregular and flat bones were in the same 
condition. The shafts of the long bones were externally but 
little different from healthy ones; but on making a longitu- 
dinal section of them, the medullary canal and the cancellated 
spaces near their extremities were dark red in colour, from con- 
gestion of the vessels and extravasation of blood into the 
areolar spaces. In other parts a peculiar fat was found, giving 
a paleness to the colour ; and the bones were near their ends so 
filled that the cartilage appeared to be of a palish yeUow colour, 
and was velvety and shghtly greasy to the touch. 

In some cases the teeth do not escape ; the crusta petrosa 
being evidently increased in thickness, and more spongy than 
natural. IsTo class or breed of horses seems exempt from this 
disease, as I have records of cases of it in carriage horses, in 
ponies, and in thorough-bred ones, whilst Professor Varnell's 
cases belong to the cart breed. It seldom affects horses above 
six years old ; frequently, indeed, the animals have ranged from 
two up to four years old ; but my later observation teaches me 
that very old horses are not exempt from the disease. Professor 
Varnell enters into a very lucid examination of the cause, and 
leaves one with the impression that it is due to food or water 
deficient in the salts of lime. Experience, however, seems to 
prove that the absence of lime is not a constant factor so far 
as the life-history of the animal can be traced, nor can it be 
conclusively proved to be due to any peculiar geological 
formation or particular locality. One of Mr. Eobinson of 
Greenock's cases was attacked while in London, during the 
summer season, with symptoms analogous to those of rheuma- 
tism, and all his cases were well-cared-for animals. It has been 
witnessed in Shetland ponies. In America the disease is called 
Big-head, from the peculiar swollen state of the jaws; it is 
there supposed to be due to the feeding upon maiie, and it has 



OSTEO-POEOSIS. 193 

latterly appeared in thorough-bred stock in Australia, where 
it is erroneously ascribed by some to forcing the growth of the 
young by over-feeding. 

Osteo-porosis is not confined to the horse and sheep ; cattle 
reared on bad Hi-drained land, poorly kept in the winter, grazed 
on sterile upland pastures during dry summers, oi otherwise iU- 
used, being liable to be affected with it. They present symptoms 
of rheumatic lameness, terminating in spontaneous fracture of 
the bones involved. 

The disease in sheep, as explained by the following history, 
kindly supplied by Mr. Eobertson of Kelso, is not uncommon. 

" Sheep of all breeds and of every age are, under certain con- 
ditions of soU and cultivation, externally liable to a peculiar 
form of non-inflammatory disease of bone, more nearly resem- 
bling osteo-porosis, as here described, than aught else I am 
aware of. 

" Every appearance of this disease with which I am acquainted 
has been in stock pastured on what is known as weak moor- 
land, recently reclaimed and limed, or fed with roots grown on 
soil of this character undergoing reclamation. It is deserving 
of notice that so long as this class of soil is left undisturbed, 
the sheep, although grazing sparsely, are in good health ; but no 
sooner is it drained and limed, and put under such rotation as is 
deemed best fitted to accelerate its being laid down again to 
grass, than a strange class of diseases make their appearance 
amongst the sheep confined to this land; amongst the most 
conspicuous of these affections is this peculiar bone disease. 

" There is nothing either in the general health of the sheep, 
their powers or manner of locomotion, or external appearance 
of the bones, which afterwards show so much alteration of 
structure, to attract attention, or even raise the suspicion that 
the animals are not in good health and doing well. 

" The first indication that there is aught seriously wrong is in 
aU probability the finding some morning of one or more of the 
flock helpless from a fractured limb ; or this condition may be 
observed actually to occur while the sheep are being turned 
by a dog in the usual course of telling and inspection. 

" The fractures, as a rule, occur in the long bones of the limbs. 
On carefully examining these bones, there is frequently little to 
be observed of an abnormal nature, on their exterior surface. 

o 



194: NON-INFLAMMATORY DISEASES OF BONES. 

Occasionally tlife periosteum will be tliicker, more vascular 
and more easily stripped off; the fractured surfaces, however^ 
or such as are exposed, on making a section through the shaft/ 
disclose great general vascularity, and consequent heightening 
in colour. 

" The medulla appears not only to contain an extra amount of 
blood-vessels loaded witli blood, but at many parts these seem 
to have ruptured, and .extravasation to have occurred. This 
heightening in colour and extravasation of blood is not only 
present in the large nutrient canal, but distributed throughout 
the entire nutrient system of the bone. Obvious alteration of 
structure in all these cases is found to exist both in the compact 
tissue of the shaft, and in the entire cancellated and compact' 
tissue of the extremities. In the former, the bony laminae 
surrounding the Haversian canals are expanded, opened out, 
and thinner, resulting in a consequent dilatation of these latter ;■, 
the same conditions exist to an equal extent in the cancellated 
tissue of the extremities. 

" Although this rarefaction of the true bone tissue may have 
proceeded to a great extent, leaving merely a thin shell of com- 
pact bone around the great medullary canal, in no case is therisi 
an entire want of bony matter, or a replacement of this by 
cartilaginous or fatty tissue. The bone will not cut with a 
knife, but may be fragile enough to admit of being crushed on 
the application of even moderate force. 

" It is no doubt from this apparent condition of the extra 
amount of blood contained in the vessels and nutrient canals,, 
its effusion, and the very dark colour imparted to the bones, 
which has led ordinary observers to speak of them as being in a; 
state of rottenness and decay. , 

"Although all breeds and ages of sheep, when circumstanced' 
as stated, seem liable to be thus affected, I have met with it; 
most frequently amongst cross-bred sheep, and in these when 
under two years of age, most probably because they are the 
class of sheep most frequently subjected to the adverse in- 
fluences mentioned. 

" In regard to the treatment of this disease, we can, from ex- 
periments which have been carried out, speak with tolerable 
certainty as respects the efBcacy of preventive measures. When' 
skeep are placed either on pasture or on roots, with such con- 



;Ti" ! GSTEO-POEOSIS. : ■ i! ' ' : 195 

ditions of soil and cultivation as indicated^ the addition to' 
this natural diet of from one quarter to one half pound daily 
of some nutritious material, as linseed cake, or a mixture of 
linseed cake, oats, and bran!, serves effectually to prevent the 
occurrence of this diseased condition; whUe, tvhen such has' 
declared itself, a change to a better soil and a different' 
geological formation will, in combination with supplemented; 
food, materially hasten a restoration to robust health. ' ' 

"At one time it was believed, and many stOl hold to the' 
opinion, that the immediately operating cause in the production 
of this diseased condition of bone was the presence of lime salts' 
in the soU, the result of the added alkali, and their transference 
to and appropriation by the animal system, thus producing a 
fragility of bone from excess of earthy constituents. Chemical, 
analysis of these bones has, however, disallowed this theory, 
even if it were not untenable on other grounds. 

" It seems most probable that this condition of mal-nutrition is' 
rather to be regarded as resulting from certain changes which- 
the treatment of the soil has brought about, in the materiali 
produced therefrom, and their unfitness when received into 
the animal body for the elaboration of healthy tissue, than 
from the passage' in an unchanged form of any material already 
existing in the soil into the component structures of the animal' 
body." 

In concluding this subject, I must give it as my own opinion 
that the disease is due to development of the vascular and 
fibrous structures of the bones, without a correspondiUg growth 
of the true osseous and cartilaginous elements ; and in 
support of this view I here quote from Kokitansky, who 
says^" Osteo-porosis consists of the excessive deveilbpment of^ 
the tissues which occupy the canals and cells of the bones ; 
whilst at the same time the actual quantity of bony tnatter 
remains unaltered." The growth of the contents of the canals 
and celts must naturally cause a rarefaction of' their walls, and 
the bone becomes increased iii volume, expanded^ as the walls of 
the expanding cavities become thinner and thinner, till at length 
apertures are formed, and cavities which communicate one with 
the other, containing a dark red medulla, traviersed by dilated 
vessfels, and which sometimes become ruptured, and the cavities 
become filled by loose or firm clots of blood. The: fact that; 



196 KON-INFLAMMATOKY DISEASES OF BONES. 

osteo-porosis has not been recorded in aged horses points out 
most strongly that it is a disease of growth ; and the circum- 
stance of the bones being fragile and easily broken, confirms 
the view that the cartilaginous basis, as well as the earthy 
constituents, is not developed ; for were the disease due to non- 
development of earthy matter only, the bones would bend, being 
more elastic than is natural ; but in this disease they are brittle, 
owing to the absence of the tough animal basis in sufficient 
quantity. 

Osteo-porosis is confounded with fatty degeneration of bone, 
but it is quite different, both physically and chemically. In the 
one case, the bone is pink or dark red, and hydrochloric acid 
produces but little change; but in fatty disease the bone is 
yellowish ; and all that is left of a piece subjected to the action 
of the acid is a small quantity of an amorphous greasy substance. 
In fatty degeneration the cartilage degenerates into fat ; in osteo- 
porosis it is not developed sufficiently, the bulk of the bone 
being composed of vascular and fibrous structures mixed with a 
portion of spongy bone ; hence they are frail, and liable to fracture. 
In one of Mr. Eobinson's cases both fore legs were broken before 
the animal was destroyed. 

It would be hazardous in our present state of knowledge to 
condescend upon the cause or causes of osteo-porosis, for it will 
be gathered from the foregoing observations that animals of 
every class, no matter how treated, are subject to it; the 
race-horse, from supposed over-feeding and over-forcing ; cattle 
from the want of proper food ; and sheep when placed upon 
pastures which have been improved by draining and liming. 

Continental writers recommend the curative treatment of the 
disease. In this country everything that has been done to 
an-est its progress, such as good food, tonics, alteratives, the 
best of attention, ventilation, &c., have all proved futile when 
it had once been established. We must therefore conclude with 
Mr. Eobertson that its prevention is to be aimed at, and 
measures taken for that purpose in every case where animals 
are placed under conditions or pastured upon land favourable to 
its development, by making such additions to their natural 
diet as to blend the whole food into a perfect pabulum, fit 
for the nourishment of all the tissues of the body ; for in all 
probability it wiU yet be discovered that the disease is due to 



OSTEO-POEOSIS. 197 

the absence of some essential ingredient of the food, or its pre- 
sence in such small quantities as to he insufficient for the 
necessities of the animal ; or the presence of some other con- 
stituent of the food in such super-abundance as to destroy the 
perfect composition of the aliment as a whole, and thus render 
it unfit for assimilation hy, or so change it as to cause it to become 
even an irritant to, the osseous system of the animal. 



FKAGILITUS OSSIUM. 

Fragility of bones results from two pathological conditions, 
namely — 1st. Fatty degeneration of the animal basis ; and 2d. 
The presence of an undue quantity of earthy materials, due to 
old age or to ostitis. 

The first form is a constitutional disease, with no symptoms 
indicative of its presence during life, discovered only after a 
fracture of such a nature as to be incurable, and when the animal 
is examined after death. — (See Photo-lithograph, Plate I., Fig. 
] .) I have, however, observed that narrow-loined horses are liable 
to this disease — ^bad thrivers, as they are called — with small 
articulations, badly-formed hocks and knees, round pasterns, 
&c., and having a tendency to fall lame from bone-spavins, ring- 
bones, or other osseous diseases. As a rule, they are middle- 
aged horses, and the post mortem examination shows the bones 
— ^more especially the pelvic and vertebral — in a peculiar greasy 
condition, yellowish in colour throughout their substance, and 
with their canceUi fiUed with a dirty yellowish fat. When 
microscopically examined, the minute structure of the bone is 
found to be iiUed with fat globules; in fact, their structure 
is not only infiltrated, but partly composed of fat, traversed, as it 
were, by the natural bony material. 

Writers upon surgery describe fatty degeneration of bone 
under the head of moUities ossium, or softening of the bones ; 
indeed, there seems to be a confusion amongst them on 
this subject, some giving the pathological anatomy of osteo- 
porosis, others of fatty degeneration. Paget, however, says 
that two diseases are described as mollities ossium, namely 
fatty degeneration, and the simpler softening of bone, or osteo- 
malacia rhachitismus adultorum, in which the bones are flexible 
rather than brittle. 



t98 NON-INFLAMMATORY DISEASES OF BONES. 

The case relateid lat page 183 goes to i prove that thei two; 
conditions are quite distinct in the horse, as in that case there 
was simply a removal of the earthy constituents, rendering the 
bones flexible and easUy cut with the knife. I contend this 
is the true moUitiesossium; whereas in the disease now under 
consideration fatty material is substituted for the cartilaginous 
basis, without removal of the earthy mattery and in this way 
the bones are rendered brittle, and liable to fracture from 
imappreciable causes. 

The second form of fragilitus ossium, 'resulting from old age, 
pan scarcel;y' be looked - upon as a disease, since it is as much 
the natural state of the senile skeleton as the soft pliable con- 
dition of the bones is that of adolescence. 

Bones, when affected by chronic inflammation, however, are 
rendered exceedingly brittle and liable to fracture ; and it is 
interesting , to note the progress of ostitis leading to such a 
condition. First of all, if the extremity of a bone be examined; 
by making a section of it, when in the early stages of inflam- 
mation, it will be discovered that the first change has been the ' 
removal of the fat from its cancelli ; that a fibrinous exudate 
has taken its place ; and that this deposition is being gradually 
replaced by osseous material. After a time, the open, areolar 
appearance of the interior of the bone assumes that of compact 
tissue, the bone at the same time increasing in weight. This 
condition may continue for a very indefinite period, and in some 
cases no further change takes place, but in others open spaces 
are formed by absorption of the new bone. These spaces are 
small at first, but become enlarged by removal of their waUs, 
and by the coalescence of two or more oi them. Thus the solid, 
compact bone again becomes cancellated, but this cancellated 
structure is very different from the original; for the' bony 
trabeculse are now deficient in animal material, are mostly 
made up of the earthy constituents of bone, and are thus brittle 
and ready to break upon the slightest application of force. The 
bones most liable to assume this condition are the tarsal, cunei- 
form, navicular, and pedal bones ; and these are all composed 
of a very thin, compact shell, and much cancellated tissue. 
This compact' layer is frequently involved in the diseased pro- 
cess going on withiri, and covered with small nodules;of bone ; at 
other times it is ulcerated on its surface, or both conditions may 



, FEAGILITUS .'OSSIUM. :! fl9'9 

(be; co-existent. The pedal : laones, howiever, when chronically 
inflamed, become absorbed at their inferior borders externally, 
jand Tondergo thp change described within their substance. 
New formations, as bone-spayins and ring-bones, when of 
long standing, are also liable to take on this action, becoming 
brittle and easily broken. 



OSTEO-SAECOMA. 

Spina ventosa, or, as it is called by Gamgee, " fibro-plastic 
.degeneration of bone," is a disease very rarely found, except in 
bomed cattle, affeetiug the lower jaws generally; but in one 
case which came under my notice the upper jaw was the seat 
of the disease. — (See Photo-Uthograph, Plate IV., Pig. 7.) These 
tiunours consist of an osseous crust, forming the walls of a cavity, 
divided into several compartments containing a reddish fluid 
tubercular material, or inspissated pus mixed with pieces of bony 
or cartilaginous substance, bounded, as it were, by cyst-like 
walls. These three conditions were all present in the case illus- 
trated, and serve to form three definite stages of the disease: — 
1st. The formation of a cyst containing a jelly-like fluid; 2d. 
The transformation of this fluid into a grey caseous material, 
which, when microscopically examined, presented a merely 
granular appearance ; and 3d The softening of the tubercular 
matter into a semi-fluid, pus-like substance, mixed with pieces 
of cartilage and bone. 

The cause of this disease has been attributed to external 
violence ; but I have great reason to doubt the accuracy of siich 
a conclusion, and I am of opinion that the causes are intrinsic, 
and due to the scrofulous diathesis. It occurs in young animals 
mostly, and is said to afiect steers more than buUs, its seat 
being the neighbourhood of the second and third molar teeth, 
where at first a small circumscribed swelling occurs. "When 
felt, the tumour is found to be hot, and that pressure causes 
some paia to the animal. At first the animal experiences no 
inconvenience ; indeed, it seems to suffer but little throughout 
the various stages of the disease, provided the teeuh do not 
become carious, when of course the sufferings of the animal 
wiU be severe, and it will lose flesh from inability to feed. 
The bullock from which the drawing was obtained was quite fatj 



200 NON-INFLAMMATORY DISEASES OF BONES. 

and sold for £29 the day before he was slaughtered, and was as 
able to masticate his food as if nothing ailed him. It is on 
record, however, that the teeth drop out of their sockets, and 
that fistulaR open into the mouth. 

Treatment, in any but the early stages, is out of the question, 
and the only thing to be done is to feed the animal, if possible, 
for the fat market. If, however, called in before the tumour 
has attained any considerable magnitude, the practitioner may 
remove it. To effect this, he must dissect the skin and sub- 
cutaneous structures from the tumour; trephine in one or 
two places, as starting-points; and remove the whole of the 
diseased structures, including the teeth surrounded by them, by 
either the bone forceps or saw. The operator must be careful 
not to leave any portion of the diseased parts, or it will most 
assuredly become the nucleus of a new growth. When the 
removal is complete, the skin is to be brought together by 
metallic or carbolised catgut sutures, and over all collodion 
or styptic colloid is to be thickly painted. In this manner the 
wound will often heal without suppuration. 

The practitioner will of course understand the necessity of 
carefully feeding the animal upon soft diet for some days after 
the operation, and that some attention must be paid to the parts 
operated upon. 



THE EFFECTS OF MERCUKT ON BONE. 

The accompanying woodcuts — for the use of which I am in- 
debted to Professor Bennett — illustrate the effects of mercury on 
the bones of a dog, the skeleton of which is now in the Museum of 
the University of Edinburgh. The history of the case is given by 
Professor Bennett in his Principles and Practice of Medicine, 
and is as follows: — " The dog lived in the shop of Mr. BaUan- 
tyne, eighteen years ago, in Carrubber's Close. At that time 
the work carried on consisted almost exclusively of painting 
with Vermillion and lacquering Japan articles. The dog, who 
never left the premises, was frequently seen lapping the Ver- 
million oil paint ; and there can be no doubt that in this way 
there was introduced into his system a considerable quantity 
of mercury. After death, the dog was dissected. Numerous 



J 



EFFECTS OF MERCURY ON BONE. 



201 



cancerous-like masses were found in tlie lungs and internal 
viscera, and his skeleton was presei-ved. It will be seen that 
the shafts of the long bones, and not their extremities, were 




Fig. 34. 




Fis. 35. 
!FlGS. 34 and 35. — Two views of the Femur. 

attacked. The disease closely resembles what may be observed 
in many other specimens of so-called syphilitic disease. Yet 
in this dog we have the positive proof that it was caused by 
mercury, as all attempts to communicate the syj)hilis to dogs by 
inoculation have failed." 



DISEASES OE THE JOINTS. 



EXPLANATION OF PHOTO-LITHOGRAPH, PLATE 11. 

1. Ehedmatoid Inflammation of Shouldbe- Joint, showing por- 
cellaneous condition of aiticular surface, and ossification of synovial 
fringes. (1.) Extremity of scapula. (2.) Upper end of humerus. 

2. ScKOFULOus Disease of Elbow-Joint of Ox, the lower ex- 
tremity of humerus being shown. (1.) Tubercular deposits repre- 
sented by the white spots. (2.) Destructive absorption of the cartilage 
and bone. 

3. Ehbumatoid Disease of Stifle-Joint, shovidng — (1.) Grooving 
of the bone, and the porcellaneous deposit ; and (2.) The formation of 
the addimentary bones described in the text. 

4. Eemoval of Aeticular Cartilage and Compact Laminal 
Layers from the surfaces of tibia and astragalus in a case of open 
joint. (1.) New ossific deposit external to the articulation. (2.) Por- 
tion of laminal layer not yet removed, but which in the specimen is 
" tunnelled under " by absorption. (3.) Lower end of tibia; which 
at (4.) contains a pit-like ulcer. 

5. Hock-Joint in Eheumatoid Bog-Spavin. (1.) Grooving of arti- 
cular surface into which the porcelain is deposited. (2.) Addimentary 
bones, formed by ossification of the synovial fringes. 

6. Fracture of Astragalus and Bone-Spavin. (1.) Astragalus. 
(2.) Bone-spavin. (3.) and (4.) Metatarsal bones. 

7. Caries of the Point of Os Calcis (Capped Hock). (1.) Sup- 
erior, and (2.) Inferior extremities of the bone. 

8. Scrofulous Inflammation of the Phalangeal Bones op Ox 
in " Foul in the foot. (1.) and (2.) Show the contrast between an 
ulcerated and healthy articulation. It will be noticed that although 
the destructive process is much advanced, there is but little or no 
attempt at repair by external deposition of bone. 

9. Tubercular or Scrofulous Inflammation op the Foot of 
A Cow, commonly called " foul." At (1.) and (2.) are weU-marked 
collections of " yeUow tubercle." 






PZA. TE a 



3 



f""^l> 








-Jf? 



CHAPTER XL 

DISEASES OF THE JOINTS. 

CLASSIFICATION OF THE JOINTS ANCHYLOSIS OF THE VERTEBRA — 

ACtTTE SYNOVITIS CHRONIC SCROFULOUS SYNOVITIS CALCIFICA- 
TION OF THE SYNOVIAL FRINGES RHEUMATOID ARTHRITIS 

MORBID CONDITION OF CARTILAGE TRAUMATIC INFLAMMATION 

OF THE JOINTS IIYDROPS-ARTICULORUM ANCHYLOSIS. 

Joints are complex in their structure, consisting of bones, arti- 
cular cartilage which covers their extremities, synovial mem- 
brane, capsular and binding ligaments, fat, blood-vessels, and 
nerves. Owing to these various component parts possessing 
different degrees of organization and vitality, it will be easUy 
understood that the diseases of the joints are both numerous and 
important, more especially when the extensive motion they are 
called upon to perform is taken into consideration. 

The joints are divided into three classes, namely, the immove- 
able, the moveable, and the mixed. The immoveable joints, or 
sutures, are those connecting flat bones together, as in the bones 
of the head, and are subject to no special diseases ; it is there-, 
fore with only the two latter classes that we have to deal. 

In the mixed joints the ends of the bones are not covered bj 
cartilage of incrustation, nor is there a true articular cavity 
lubricated by synovia ; the bones, joined together by powerful 
binding ligaments, are yet separated from each other by a thick 
broad pad or disc of fibro-cartUage. This simple kind of articu- 
lation is subject to but one form of disease, namely, chronic 
inflammation, causing the gradual conversion of the fibro-carti- 
laginous pad into bony tissue. In this manner the vertebral 
column, which is extremely elastic and mobile in its entirety, is 
converted, more especially in the lumbar and dorsal regions, 
into a stiff, unyielding structure, rendering the movements of 



204 DISEASES OF THE JOINTS. 

the horse uneasy to its rider, and destroying that motion of 
adaptability which is pre-eminently characteristic of that ani- 
mal, and -which enables it to perform an amount of speed with 
a weight upon the back that would, without this provision, be 
sufficient to cause by its concussion such injury to its internal 
economy as to produce disease, and even death. 

Causes. — This disease is generally produced by the animal 
being compelled to bear a weight disproportionate to its 
strength. In some cases, however, it proceeds from no external 
appreciable cause ; it must therefore arise from a constitutional 
diathesis; the bones becoming fragile, fatty, and degenerate 
in condition, liable to fracture from trivial causes, such as the 
moderate contraction of the muscles attached to them, or even 
to be spontaneously broken. (See Photo-lithograph, Plate IV., 
Pig. 1.) 

,The specimen from which this plate is taken beautifully 
illustrates this peculiar pathological condition. When newly 
prepared, and up to the present time, it is found to resemble, in 
its external appearance, an old fossil bone of a dirty rusty-brown 
colour, greasy to the touch, and crumbling under moderate pres- 
sure. Microscopically examined, it presented numerous oil 
globules, its bone corpuscles much altered in shape, and in 
many of their special characteristics. It will be seen that an 
old-standing fracture exists, and that a process of repair, repre- 
sented by the enlargement, with a fissure running through its 
whole thickness, had gone on to a considerable extent. The 
animal from which the specimen was taken presented no symp- 
toms of having its back in this condition, nor of the fracture 
during life. He was a very old pony, and was accidentally 
bought for dissection. The whole of his spinal column, from 
the sacrum to the middle of the cervical region, was more or less 
affected ; the anchylosis being complete between all the lumbar 
and dorsal vertebrae, but only in the rudimentary state in those 
of the cervical region. Had this animal been cast for an opera- 
tion, the result would inevitably have been a broken back, no 
matter how carefully such casting had been performed. Veteri- 
narians will bear this in mind, and are here exhorted to make a 
careful post mortem examination of every case of such an acci- 
dent, not only as to the mere presence of the fracture, but into 
the pathological condition of the bones. 



ANCHYLOSIS OF THE VERTEBRA. 205 

The symptoms of this disease are very obscure ; some slight 
stiffness about the loins may be observable ; disinclination on the 
part of the horse to lie down in the stable, more or less clonic 
spasm of the limibar and gluteal muscles (shivering), or some 
degree of stringhalt. 

Cart-horses are more subject to this disease than any other 
class of our patients, and this is explained by the fact that they 
are loaded with heavy weights during the period of their growth, 
when their age and strength are not calculated to bear them. 
When hunters and hacks, as age advances, become stilty in 
their action, unpleasant to ride, the change is often as much due 
to this increased stiffness in the back as to that in the joints of 
the extremities. 

Sometimes horses suspected to be suffering from this disease 
present symptoms of its temporary aggravation by a greater 
degree of immobility in the loins and back, a greater extent of 
the spasmodic action before referred to, and by sigus of partial 
paralysis ; there wiU. be reeling of the gait, crossing and draw- 
ing inwards of the hind feet, inability, without danger of falling, 
to turn round quickly, great difficulty in backing, during which 
process a peculiarly sudden quivering elevation of the tail may 
often be observed. 

The meninges of the cord are in such cases more or less in- 
volved in the inflammatory action. 

This aggravation may be produced by a slight cold, indiges- 
tion, or other trivial external or internal cause. 

For the original disease nothing can be recommended except 
the removal of its cause, if possible, and a period of rest ; but 
for the exacerbations active treatment is required. The con- 
stitutional treatment will depend upon the cause. As a rule, 
a purgative — if its administration is not contra-indicated by the 
presence of a catarrhal affection or chest disease — should be 
given, and belladonna in moderate doses, in preference to any 
other sedative, because of its special effect upon the cord, and 
its power of diminishing muscular contractility. The local treat- 
ment to consist of fomentations to the loins, or a sheep-skin, and 
the application of gently stimulating embrocations. 

If these do not succeed, a blister may be applied with advan- 
tage. If the hair be clipped for a space four inches broad, aud 
twelve to sixteen inches long, upon both sides of the spine, the 



206 DISEASES OF THE JOINTS. 

hair around its borders well saturated witli grease, and the 
blister carefully applied to the clipped patch only, no danger, 
may be apprehended. It should, however, be washed off at the 
end of twenty-four hours. .; , 

The diathrodial or true joints are divided into three varieties,, 
naiiiely, artlirodia or gliding .joints, the enarthrodia, and the 
ginglymoid. 

The arthrodia are liable to inflammation, and ulceration of the 
articular surfaces, arising primarily in the bones entering into 
their conformation. 

The enarthrodia, or ball-and-socket joints, are in our patients 
seldom diseased, and generally the cause of such disease arises 
intrinsically, such as from the rheumatoid or the tubercular 
diathesis. They are clothed by muscular tissue, and but rarely 
suffer from accidents. 

The ginglymoid or hinged joints are exposed to injuries from 
without, such as sprains and punctures, which are productive of 
a variety of diseases, namely, inflammation of the synovial mem- 
brane (acute and chronic), destruction of the articular cartilage, 
caries of the extremities of the bones, a deposition of calcareous 
matter in their structure, called the porcellaneous deposit, loose 
bodies in the synovial cavity, defective secretion of synovia, in-- 
creased secretion of it, constituting dropsy of the articulation, 
and anchylosis ; these are also, liable to be accidentally opened. 

When inflammation of & joint arises from a strain, the liga- 
ments are not only stretched, but are more or less lacerated at; 
their points of attachment. These ligaments, it will be re- 
membered are lined upon their unattached internal surfaces' 
by synovial membrane, which becomes inflamed when they are 
strained, and from these points the inflammation extends along 
the whole synovial surface of the articulation. 

The true hock-joint, namely, that constituted by the tibia 
and astragalus, may be taken as a type in our description of 
these various forms of pathological changes. 



INFLAMMATION OF THE SYNOVIAL MEMBRANE, OK 
ACUTE SYNOVITIS. 

The primary effects of inflammation upon this membrane are- 
more or less injection of the vessels, opacity, and dulness of itsf 



ACUTE' SYNOVITIS • c 207 

strface. In some cases it will be of an extremely dark red 
colour, owing to congestion, and may present an appearance of 
brownish or even crimson spots. 

At the outset ef the congestion, this, like all other secreting 
membranes, is preternaturaUy dry upon its surface, owing to 
its secreting powers being: for a time in abeyance ; but very 
shortly there will be a superabundant secretion of an unhealthy 
synovia, aqueous in its character, and containing flakes of lymph. 
The membrane becomes thickened by interstitial deposition; loses 
its translucency, and becomes rough on its internal surface, to 
which flakes of lymph are found adherent. This exudation of 
lymph is confined to the synovial surface, and does not extend 
to the articidar cartilage. In severe cases suppuration may 
occur, and, if the disease cannot be. arrested, ulceration of the 
cartilage is sure to follow. 

The synovial fringes will be found to be in a higher state of 
inflammation than any other portion of the membrane. 

Any true joint, in the body may suffer from inflammation of 
its synovial membrane, but some are more liable than others. 
This, will be afterwards referred to under the head of Lame- 
ness. 

The causes are strains, puncture^ the localisation of rheumatic 
poison, the deposition of tubercular matter into the substance, and 
upon.the surface of the synovial membrane, as in the "' grapes" of 
horned cattle, and from the deposition in and around the joints 
of mineral poisons, as seen in horses which are employed in and 
about large smelting works. 

Tlie symptoms are lameness and fever, varying in their degree 
according to the severity of the articular inflammation. If the 
disease be severe, the pain acute, the fever wlU be high, the pulse 
quick and irritable, partial sweats bedew the body, but more 
especially the affected limb, and the lameness wiH be so great 
that the animal cannot put its foot to the ground. The affected 
joint soon commences to swell ; the swelling being tense, yet 
elastic, in the first stages ; but soon becoming hard, firm, and 
unyielding, from an exudation into the subcutaneous structures. 
There wiU be increased heat of the parts, and they wiU be 
tender to the touch. 

- It: is of the utmost consequence to arrest the disease before 
the cartUage becomes , involved, or it will be incurable; audi 



208 DISEASES OF THE JOINTS. 

if it be in one of the posterior articulations, such as the hock, 
it is often necessary to place the animal in slings. Fomenta- 
tions of warm water must be applied to the part repeatedly, 
and some soothing application rubbed on, such as a weak 
solution of opium or aconite. The shoe must be removed ; 
but if the practitioner thinks that the patient wUl be able to 
rest better with a high-heeled shoe, it should be immediately 
applied. 

The constitutional treatment will depend upon the severity 
of the symptoms. In all cases a moderately strong purgative is 
beneiicial ; and if the pain be very great, opium, two or three 
times a day, wUl best relieve it ; care being taken that the bowels 
do not become constipated. When the pain is less acute, aconite 
may be used in preference to the opium. 

If these remedies fail to give relief in the course of three or 
four days, a blister must be applied. No bad results need be 
feared from such an application. In many cases the pain will 
subside and the fever abate in the course of a few hours after 
the blister has commenced to act. 

If any lameness and thickening of the joint threaten to 
remain, it may be necessary to apply the actual cautery. 

In conclusion, it must be borne in mind that absolute repose 
of the part affected, if such a thing were possible in our prac- 
tice, must be the first and greatest consideration in the treat- 
ment of the disease. 



CHRONIC SCROFULOUS SYNOVITIS. 
(See Photo-lithograph, Plate II., Fig. 2.) 

This affection is, within my experience, confined to horned 
cattle, where the process of " in-and-in" breeding has been 
carried out to too great an extent. The joints most usually 
affected are the elbow and stifle, and the foot-joints in the 
disease called " foul in the foot." It attacks animals of aU ages, 
but generally they are three years old and upwards. 

At the outset, it is difficult of diagnosis, the symptoms being a 
lameness arising from no apparent cause, without swelling, or 
any indication of pain other than the lameness ; but after a time 
a slight swelling may appear about the joint affected, without 



CHRONIC SCROFULOUS SYNOVITIS. 209 

much heat, or pain upon pressure. The swelling gradually 
enlarges, and is of a doughy, elastic nature ; the limb below it 
seems to waste ; the animal begins to lose condition ; the lame- 
ness and pain increase ; and suppuration may take place ; but 
this is by no means a uniform result. 

In some cases constitutional symptoms of scrofula may pre- 
cede the manifestation of the joint disease; when this is the 
case, the diagnosis wUl be rendered easy, and the practitioner 
need not hesitate to condemn the animal to slaughter. 

Pathological Anatomy. — The structures around the joint will 
be found infiltrated in circumscribed spots with a yeUowish- 
white, caseous material, in which the Bacillus tuberculosis may 
occasionally be found, and the synovial membrane studded upon 
its surface with yellowish- white globular bodies, which, when 
cut into, present the same tubercular character. These bodies 
vary from the size of a turnip seed to that of a large pea. 

The membrane itself is found of a greyish- white colour, and 
gelatinous in appearance, with its vessels in some parts highly 
injected; the synovial fluid curdy, and more opaque than 
natural ; the cartilages of incrustation, as well as the ends of the 
bones removed by ulceration, causing the interior of the joint to 
present a worm-eaten appearance. In the interior of the bones, 
round spots of tubercular matter are seen in the cancelli. 

In dissecting the various structures, it will be found that the 
skin, the subcutaneous tissues, and synovial membrane are matted 
together into an almost inseparable mass. 

Hereditary predisposition is an acknowledged fact, and when- 
ever scrofula in any of its forms makes its appearance in a herd, 
it will be high time to infuse new blood into it. Exceptional 
cases may, however, be induced by neglect or other debilitating 
influence. 

The treatment can be but palliative ; the preparation of the 
animal for the butcher being the only end to be gained. The 
application of blisters to the part will often remove the inflamma- 
tion for a brief period, and thus allow the animal to put on fat. 

The patient must be stall-fed, kept as quiet as possible ; to 
have food of the most fattening nature ; cod-liver oil may be 
given night and morning. If the disease has made much pro- 
gress before the practitioner is called in, or if, in spite of the 
treatment recommended, it continue to advance, the animal had 
better be put out of its suffering. 

P 



210 DISEASES OF THE JOINTS. j 

CALCIFICATION. OF THE SYNOVIAL FElkGES. 

In the dissection of old horses which have been stiff in their 
joints, the synovial fringes are often found in a state of calcifica- 
tion, the ossific or calcareous deposits varying from the size of a 
millet seed to that of a small bean. These occasionally become 
detached, and find their way into the interior of the articulation, 
causing sudden aud violent lameness, which ,disappea,rs as sud- 
denly as it came, by the detached body regaining its original 
position. A condition similar to this has been termed fimbriated 
synovial membrane by pathologists. In the horse the stifle 
joint is that most commonly affected. 

KHEUMATOID ARTHRITIS. 

The condition of the synovial membrane described in the last 
paragraph is probably due io a peculiar inflammation, which has 
been termed rheumatic gout or chronic rheumatic arthritis — a 
disease differing from gout and rheumatism in many particulars, 
although possessing some characteristics common to both. This 
affection in man has been studied and described by Dr. Hay- 
garth of Bath, by Cruveilhier, and more particularly by Dr. 
Adains of Dublin. ^ By Dr. Haygarth it was called " nodosity 
of , the joints;" and by Cruveilhier, "uswe des cartilages articu- 
iaires." To both of these terms Dr. Adains takes exception, 
and says — " The term suggested by Cruveilhier, it is plain, 
would locaUse the disease too much, confining it hierely to one 
of the articular textures ; whereas we know that, when fully 
formed, most, if not all,' of these textmes are implicated ; and 
as to the term ' nodosity of the joints,' the swellings of the 
joints which we notice in this disease are by no meails hard, as 
the term nodosity would imply. On the contrary, ks in its 
early Stages the ^WelUngS are principally' constituted by the 
effusion of muct synovial fluid into the interior of the joint, 
they are soft and fluctuating." 

I am sure that every veterinary surgeon of experience, when 
he has read the following account, abbreviated from Dr. Adains' 
work, will at once see the great resemblahce it bears to many 
cases he has met with in his practice. 

" The disease may be a constitutional or a local disorder; the 

1 A Treaiiae on Sheumatic (joui, or Chronic Rheumatic Arthritis, all of the Joint*,, 



RHEUMATOID ARTHRITIS. 211 

constitutional originating in sedentary pursuits, sudden exposure 
to cold when the tody has been over-heated, or as a sequel t6 
rheumatic fever ; the local, from habitual over-exertion of a par- 
ticular joint, or from accident." 

• Symptoms. — A singular rigiditj"- in the affected joints, which, 
when first moved, emit a craclding sound. The crackling sen- 
sation, felt as well as heard in the human patient, and the 
rigidity of the limbs, followed by pains, are very considerable at 
the moment the patient commences to move about, particularly 
in the morning, after the repose of the night ; and in some cases 
there are painful spasms of the muscles. 

The veterinarian frequently finds both these symptoms, namely, 
the craclding noise and the painful and spasmodic uplifting of 
the limbs, especially the hind ones, in many of his patients, 
whose joints present the other symptoms of the disease in man 
■—the swelling, pain, and tenderness to the touch. 

The swelling in and around the affected joints, which is 
noticed in the earlier stages of the disease, arises principally 
ftom the increased effusion into the synovial sacs of the articu- 
lation, a result of the chronic synovitis which at this period 
exists. In the later stages of the affection, exostotic growths 
can be occasionally felt through the integuments. — (See Photo- 
lithograph, Plate II., Figs. 1, 3, and 5.) These spring from the- 
margins of the articular surfaces, as well as from the periosteum 
and bone in the neighbourhood of the diseased joint. In the 
tibio-femoral articulation (stifle-joint) rims of new bones can be 
seen to range themselves along the margin of the condyles of 
the femur and tibia. — (See particularly - Pig. 3 in the game 
plate.) ' 

Articular rigidity, or false anchylosis, is not an Unusual c6n- 
sequence of the disease ; but true anchylosis, or the complete 
fusion together of two bones, is exceedingly rare ; nor does the 
disease in its ordinary course proceed to suppuration. 

The synovial bursse in the neighbourhood of the affected joint 
are occasionally found disteiided, and Synovial cysts become, as 
it were accidentally, -developed in the areolar tissue siirroundinj^ 
the affected articulation, having no communication with the 
diseased joint As the disease advances, the fluid contained 
in these cysts may become absorbed, and the sacs converted into 
solid tumours. • ' 



212 DISEASES OF THE JOINTS. 

Anatomical character of the Disease. — The capsules of the 
joint are thickened, and at the same time distended with a 
large quantity of synovial fluid. At a later stage the fluid 
is removed by absorption, and the capsular membranes acquire 
a preternatural density. Some of the normal structures, as the 
round ligament in the hip, and the semi-lunar cartilages in 
the stifle-joint, are completely absorbed, if the joint has been 
long and severely affected. The lateral ligaments of the 
ginglymoid joints become preternaturally elongated, and new 
growths, varying in consistence — some being cartilaginous 
throughout, others bony in their centres and cartilaginous 
at their circumference — are found in and around the affected 
joints. These are first developed in the synovial membrane, 
and are almost always attached to it by a slender cord, or 
by a broad base; and around the rim of the cotyloid and 
glenoid cavities additional foreign bodies — called by Adams 
"addimentary bones" — are usually found deepening and en- 
larging the " cavities of reception" for the heads and condyles 
of bones composing the articidations. — (See Photo-lithograph, 
Plate I., Fig. 2.) The articular cartilages are removed, and 
their place supplied by an ivory-Hke enamel — the porcel- 
laneous deposit — in the hip and shoulder joints, the surfaces 
of the bones become as smooth, in whole or in part, aa an 
ivory ball. — (See Photo-lithograph, Plate II., Fig. 1.) In 
the ginglymoid joints the place of the removed cartilage is 
supplied by means of patches of ivory or porcelain-like enamel, 
marked out by parallel grooves, hoUowed out in the direction 
of the movements of extension and flexion. — (See Photo- 
lithograph, Plate II., Figs. 3 and 5.) 

I think that I have produced sufficient evidence from the 
symptoms during life, and the appearances of the bones after 
death, to prove the similarity, if not the identity, of this dis- 
ease with the rheumatic gout, or more properly the rheumatoid 
afiection of the joints of the himian being. Wliat veterinary 
surgeon can have failed to notice the peculiar stiffness of the 
limbs, and the crackling noise emitted when the joints are 
moved in some cases of bog-spavin and navicular lameness? 
And no one, I am sure, is prepared to deny that the peculiar 
alterations of structure and the intractable nature of the 
morbid processes are not due to a diathesis or constitutional con- 
dition similar to that which in man predisposes to this malady. 



EIIEUMATOID AETHEITIS. 213 

In support of this view of the pathology of this disease, I take 
the liberty of quoting some remarks made by Dr. G. W. Balfour 
of Edinburgh in a clinical lecture published in the Edinburgh 
Medical Journal, February 1870, page 713. He says — "You 
may remember, at the close of my last lecture, that I exhibited 
to you the bones of a horse affected with rheumatoid arthritis. 
The case to which I then referred is still under treatment, 
though improved ; and I purpose referring now more at large to 
the subject. I brought these horse bones the other day for 
several distinct reasons: — 1st. To show you well-marked ex- 
amples of eburnation on a larger scale than we ever have them 
in human joints ; 2d. To show you that this eburnation, in the 
horse at least, is not confined to the surface of the bone — ^is not 
therefore produced, as has been supposed, by mere consolidation 
and polishing produced by friction, as you would polish a piece 
of hard wood or dead bone ; for you remember, in the one bone, 
the OS naviculare — a sesamoid bone, not exposed to friction or 
pressure at all — this eburnation had extended throughout the 
whole substance of the bone, showing that probably the process 
is an integral part of the disease, and does not depend on friction 
at all, — as, indeed, in living bones we could scarcely expect 
would be the case ; and M. To show that horses, who live so 
very differently from man, both as regards food and drink, and 
who never have gout, are yet commonly affected by a disease 
which produces precisely the same pathological results as rheu- 
matoid arthritis in man, thus affording additional proof that 
rheumatoid arthritis has nothing gouty in its nature; and 
showing that, to obtain anything like a proper and profitable 
pathological history of this disease, we must include the lower 
animals in our survey. As yet very little is known of rheuma- 
toid arthritis, and yet it is of importance to know that little ; 
because it is of the utmost consequence to recognise both the 
acute and chronic disease, the treatment being so dissimilar 
from that of the diseases with which they are apt to be con- 
founded — chiefly rheumatism and gout — but which may also in 
the early stages include locomotor ataxy and Bright's disease, both 
of which are frequently associated with pains which might be 
mistaken for those of rheumatoid arthritis, an old disease, long 
known by those skilled, but little recognised generally by the 

profession Eheumatoid arthritis appears to be a 

disease arising from exposure to cold and damp, but only in a 



214' DISEASES OF THE JOINTS. 

person constitutionally predisposed by debility from some cause 
or other. But, truly, we know nothing certain in regard to this, 
and we require to have our knowledge of human pathology col- 
lated with that of the horse before we can form any rational 
theory on the subject. The blood, the urine, and the perspira- 
tion have all been analysed with merely negative results, and 
yet the morbid anatomy of the disease is perhaps the richest and 
the most extraordinary belonging to any complaint, the disease 
affecting, in its peculiar way, every bone and every joint in the 
body. In the early stage of the disease, there is found simply 
effusion of synovia, with vascular injections, signs of arthritis ; 
at a later stage the fluid becomes absorbed, the capsular mem- 
brane thickened, and the cartilage ulcerated. At a very early 
period this cartilage splits up, and becomes removed apparently 
by a slow process of absorption, the whole surface of the joint 
being then denuded, the osseous surface becoming polished and 
eburnated, as in those specimens." 

The treatment can, generally, only be palliative, and is chiefly 
constitutional.^ The administration of alkalies — particularly 
potash — is sometimes followed by amelioration of the symptoms. 
Salicylate of soda has also been given in some cases with marked 
beneficial results, but these are inconstant. The bowels should 
be regulated by an occasional purgative, the animal carefully 
fed, and put to slow work, kept in a dry stable, and when any 
sudden increase of lameness, denoting a fresh attack, occurs, 
fomentations, or perhaps moderate blisters, are to be prescribed. 

MORBID CONDITION OF CARTILAGE. 

Articular cartilage becomes diseased in consequence of syno- 
vitis, disease of the bone to which it adheres, or independently 
of any morbid condition of adjacent structures, and such disease 
may commence upon its free or its attached surface, or in the 
middle of its substance. 

In violent inflammation of joints, as those arising from punc- 
ture, the destruction of the cartilage is accompanied, or even 
preceded, by the destructive absorption of the vascular extremity 
of the bone immediately contiguous to its articular laminal layer. 
In this manner we can explain the presence of floating pieces of 
cartilage and bone in the synovial fluid. 



MORBID CONDITION OF CAETILAGE. 215 

Cartilage may become destroyed from disease arising within 
itself, independently of any morbid condition in tlie bones or 
synovial membrane ; and to account for this, seeing that carti- 
lage is a non-vascular structure, Goodsir, Eedferii, and others 
made many important investigations. 

The anatomist will be aware that cartilage in a healthy state, 
when microscopically examined, is seen to consist of a homo- 
geneous matrix, called the hyaline substance, mixed with fibrous 
tissue in fibro-cartilage, and nucleated cells, called the cartilage 
corpuscles, embedded in its sub- 






stance, arranged in a certain 
order. Cartilage contains no 
blood-vessels, but derives its 
nourishment by imbibition from 
the surrounding fluids and tex- 
tures. In the large joints, 
blood-vessels may occasionally 
be seen penetrating the cartilage, 
but these do not seem to form 
nutrient loops ; hence, to all 
intents and purposes, articular ' 7^ 

cartilage contains no blood- 1''I0. 36.— Healthy cartilage. 

vessels, nor have any nerves been discovered in it ; consequently, 

it possesses no sensibility. 

It was iirst demonstrated by Goodsir that ulceration of 
cartilage is accompanied by enlargement and alteration in the 
form and arrangement of the cells. " Instead of being of their 
usual form, they are larger, rounded, or oviform, and instead of 
two or three nucleated cells in their interior, contain a mass 
of them. At the very edge of the ulcerated cartilage, the 
cellular contents communicate with a diseased membrane by 
openings more or less extended. Some of the ovoidal masses 
in the enlarged corpuscles may be seen half released from their 
cavities by the removal of the cartilage." ^ Goodsir describes 
a false membrane of a gelatinous nature, which covers the 
cartOage during the progress of the disease, both in scrofulous 
and simple inflammation. As far as my investigations go, 1 
have only found this membrane in two instances. 

The texture of the cartilage does not, during the progress 
^ GooDsiK's Anatomical and Pathological Observatiom. 



216 



DISEASES OF THE JOINTS. 



of the ulceration, exhibit any traces of vascularity, and the 
membrane, which was supposed by Goodsir to be the cause of 
the ulceration, is regarded as the result of the disease. The 
formation of this false membrane, which is sometimes on the 
bone, sometimes on the attached surface of the cartilage, has 
conveyed the erroneous impression, entertained by some ob- 
servers, that in one form of destruction of articular cartilages, 
the destruction is preceded by the formation of vessels in the 
substance of the cartilage itself. It is quite certain that in 
nearly all instances of destruction of the articular cartilages, 
in the lower animals at least, there have been extensive ulcera- 
tions without the presence of any vascular membrane ; and in 
one instance that fell under my notice a false membrane was 



J ^ 



j^9>-^-^ 



ps>i), 






«3 ® /j-"-^ 



<s 






o:. 



CO) 







p 



om 






, sS* 






5, 






-1 



■*-3 




Fig. 37. 



Fig. 38. 



Fig. 37. — Diseased articular cartilage, showing the enlargement of the cor- 
puscles, the increase of the nuclei within them, and their escape into the 
softened matrix. — (BBDrEEN.) 

Fig. 38. — Deepest part of a vertical section from the cuneiform surface of 
the semi-lunar bone, showing the cells, with thickened walls, — (Redfeen.) 

found covering the articular surface of the astragalus, the 
cartilage of which presented no signs of ulceration ; whilst the 
tibial cartilage of the same joint was ulcerated without being 
covered by any adventitious membrane. 

The further changes are the bursting of the enlarged cells 
at the surface of the cartilage, which by this change becomes 
disintegrated. In some cases, the nuclei which have escaped 
from the cells become elongated, and incorporated with the 



MDEBID CONDITION OF CARTILAGE. 



217 



hyaline sutstance, giving it unusual softness, and causing it to 
swell, fibriUate, and split into fibrous bands projecting into the 
joint. In other cases, the nuclei degenerate into fatty material 




Fig. 41. 

Fig. 39. — Cartilage from diseased human patella, showing on the surface 
fibrous tissue with imbedded cells and nuclei.— (EEDrEEN.) This figure repre- 
sents very exactly the commencement of the fibrillation and splitting up of the 
cartilage, lining the inferior surface of the navicular bone in navicular disease, 
before adhesion has taken place, between the bone and tendon. 

Fie. 40 shows a more complete formation of bands and fibres upon the 
surface of the cartilage. — (Eedfern.) 

Fig. 41. — Vertical section from the cartilage of the central part of the 
glenoid cavity of the (human) tibia, showing the splitting into fibres on the 
Kurface.— (Eedfeen.) This appearance of the cartUage represents very fairly 
the condition of the navicular cartilage when the bone and tendon have be- 
come adherent. 



218 DISEASES OF THE JOINTS. 

within the cartilage corpuscles. Another change is the infiltra- 
tion of the cartilage with the salts of lime, this change com- 
mencing in the cell wall. This may often be seen in the 
cartilage of the navicular bone. The alteration in the hyaline 
substance consists in its losing its glistening appearance, and 
being split up into shreds of fibres projecting into the joint. 

Dr. Eedfern has arrived at the following conclusions from his 
inquiries into this subject : — 

Is^. That all the known forms of disease in articular cartilage 
are connected with changes in the texture, which are essentially 
similar to each other. 

2d. That during the progress of these changes the cells of the 
cartilage become enlarged, rounded, and filled with corpuscles, 
in lieu of healthy cells ; bursting subsequently, and discharging 
the contents into the texture on the surface ; whilst the hyaline 
substance splits into bands and fibres, and the changed hyaline 
substance, and the discharged corpuscles of the cells afterwards 
form, in many cases, a fibro-nucleated membrane on the surface 
of the diseased cartilage. 

3d That these changes are referable only to an abnormal 
nutrition as their immediate cause, and in no case to mechanical 
or chemical actions, such as attrition, or digestion in a diseased 
secretion. 

Ath. That most extensive disease may go on in many joints at 
the same time, and may proceed to destroy the whole thickness 
of the cartilage in particular parts, without the patient's know- 
ledge, and while he is engaged in active occupation. 

hth. That the disease commences most frequently on the free 
surface, but may proceed from the bone to affect the attached 
surface, or may take place in the middle of the thickness of the 
cartilage. 

6iA. That it is at least very doubtful if the symptoms which 
are believed to indicate the existence of ulceration of articular 
cartilages are not really dependent on a morbid change in the 
bone. 

^th. That disease of the whole thickness of an artictdar carti- 
lage at particular parts admits of a natural cure, by the formation 
of a fibro-nucleated membrane from the substance of the cartilage, 
without the occurrence of any new exudation. 

When cartilage is destroyed, it is never reproduced. If the 



MOKBID CONDITION OF CARTILAGE. 219 

destruction be superficial, the breach may be repaired by the 
formation of the fibro-nucleated membrane. In such cases the 
affected part will present a velvety appearance. If the synovial 
membrane be involved, the fibro-nucleated membrane may be 
incorporated with an exudation from the synovial surface. 

Dr. Eedfern, in his researches On the Healing of Wounds 
in Articular Cartilages, has satisfactorily demonstrated that the 
repair of cartilage is always a very slow process. In one experi- 
ment, in which he had made three incisions into the cartilage of 
a patella, and two into that of the trochlear surface of the femur 
of a dog, he found that no union had taken place in twenty-nine 
weeks, but a reparative process had just commenced. In another 
case, similar incisions were firmly united by fibrous tissue in 
twenty-four weeks and five days. 

The appearance of the parts, upon examination by Dr. Eedfern 
at the end of this time, I beg to give in his own words : — 

" A slightly increased quantity of synovia exists in the joint ; 
the patella rests by the external half of its articular surface on 
the inner side of the internal condyle of the femur, and the part 
of the fibrous capsule of the joint which lies upon the trochlear 
surface of the femur, and glides over it, presents a dense wliite 
and smooth spot, similar in appearance to fibro-cartilage, and of 
exactly the same size and shape as the trochlea. The edges of 
the trochlear surface of the femur, and the vertical ridge on the 
cartilage of the patella, are less prominent than usual, and 
rounded. The cartilage of the femur appears perfectly healthy, 
and that of the tibia somewhat softer than natural, and the car- 
tilage of the patella is more transparent, and has a small perfora- 
tion in its centre leading down to the bone. The position of the 
incisions is difi&cult to see on the patella, and is only marked by 
the slightest curvilinear depressions ; on the femur, one incision 
is recognised with the greatest difficulty, and the position of the 
other cannot be seen with the naked eye. 

" On microscopical examination, the superficial cells over a 
considerable extent of the surface of the cartilage of the patella, 
and especially in the neighbourhood of the central depression, 
have become much enlarged, many measuring ^-jV^ of an inch 
in diameter ; they are nearly spherical, and their contents appear 
to have divided into three or four masses like nuclei; they are 
lodged in hyaline substance of greater transparency and much 



220 DISEASES OF THE JOINTS. 

greater softness than ordinary, so that the cells can be pressed 
out of it. 

" In the neighbourhood of the incisions into the cartilage of 
the patella, and upon the trochlear surface of the femur, though 
not extending upon the condyloid surfaces, the substance of 
the superficial layers of the cartilage has become converted 
into a membrane composed of granules, nuclei, and fibres. 
The formation of this membrane may readily be traced by an 
examination of it at the line of junction of the trochlear and 
condyloid surfaces, where it becomes thin before it ceases to be 
observed. The contents of the cells first become granular, and 
the hyaline substance soft and more transparent ; the walls of 
the cells disappear gradually, and scarcely anything but cell 
membranes, granules, and molecules, lying in a hyaline mass, 
can be seen ; fibres are then formed between the nuclei, and the 
latter either disappear altogether or elongate into nuclear fibres, 
and thus a dense fibrous mass is produced. If during this pro- 
cess the cells have become larger than natural, they give io the 
junction of the cartilage and membrane a notched appearance, 
by bursting and discharging their contents into the latter ; but 
if no enlargement has taken place, the textures run into each 
other so insensibly that no distinct line of demarcation can be 
drawn between them. 

" The portions of the texture through which incisions were 
made present similar appearances in every instance. Not the 
slightest difficulty is experienced in making sections through 
both the cut surfaces and the substance by which they are 
firmly united. Such sections show the cut surfaces to be very 
uneven, and hollowed into small pits of the size of the cartilage 
cells of these parts. The pits are obviously produced by the 
half-destroyed cells, the former contents of which are now seen 
lying on the surface. No evident change has taken place in 
the texture of the cartilage at a little distance from the cut 
surfaces, except that here and there the intercellular substance 
presents a fibrous appearance. There is no obvious enlarge- 
ment of the cells, or crowding of their interior with corpuscles, 
as is frequently seen to occur under similar circumstances. 
The substance uniting the cut surfaces consists of a hyaline, 
granular, and indistinctly striated mass, in which there are 
numbers of rounded, oblong, elongating, or irregularly shaped 



MORBID CONDITION OF CARTILAGE. 



221 



corpuscles, varying in size from -^lyx)-^ to 



^TTiTiT 



of an inch 



in diameter, tliose in the adjacent cartilage measuring more 
imiformly about ^o-g- of an inch. The corpuscles are more 
numerous in the substance connecting the cut surfaces than iu 
the cartilage itself, and the intercellular substance of the same 
part is slightly more transparent than that of the adjacent 
texture, the appearance of fibres being most distinct in those 
parts which are directly in contact with the cartilaginous sur- 
faces. — (Fig. 42.) In sections obtained from the cartilage of 
the femoral trochlea the mass between the cut surfaces is less 
transparent, its fibres are much more perfect, and the corpuscles 
are smaller and less easily seen.- — (Fig. 43.) The fibrous and 
nucleated membrane formed on the surface of the cartilage is 
continuous with the uniting medium, and differs from it merely 
in having its fibres parallel to the surface. 







fc-4 


"■— --"^^^^^ 






Fig 42 

Fie. 42. — Vertical section of the cartilage of the patella of a dog passing 
through an oblique incision made twenty-four weelcs and five days before 
examination, and showing perfect and firm union of the cut surfaces. — 
(Kedfekn.) 

Tig. 43. —Section of the cartilage of the femur of a dog passing through 
an oblique incision made twenty-four weeks and five days before examina- 
tion, and showing the perfect fibrous tissue developed in the healing of the 
-wound. — (Redpebn. ) 

" It may be here remarked, that the lameness which occurred 
in this case is by no means to be viewed as the result of the 
injury to the cartilages ; for except when dislocation, or some 
other accidental occurrence, takes place, incisions in the articu- 
lar cartilages of the knee-joints of dogs are attended with no 
lameness or evidence of suffering whatever, after the first few 
days, which are required for the healing of the external wound. 
Neither is it to be supposed that articular cartilages are in a 
favourable position for the healing of wounds ; for, indepen- 
dently of the continued movement, which is no less detri- 



222 DISEASES OF THE JOINTS. 

mental here than in the healing of ordinary wounds^ many, 
actions which take place in these textures proceed very slowly, 
and therefore are in greater danger of being interfered with 
in their progress. In an instance in which I made three, 
incisions into the cartilage of the patella, and two into that of 
the trochlear surface of the femur, no adhesion had taken place 
in any of the instances when the parts were examined twenty- 
nine weeks afterwards, though no inflammation of the joint, 
dislocation, lameness, or other apparent cause for the want of 
union had occurred. Yet some of the cut surfaces were in 
such close contact, before the parts were examined by means 
of sections, as to lead to the supposition that union had taken 
place. On the examination of these wounds, no effused matter 
of any kind appeared on the perfectly smooth cut surfaces; 
but as the cells near to them in the substance of the cartilage 
were obviously enlarged and rounded, having in their interior 
three or four corpuscles into which their nucleus appeared to 
have divided, or a number of bright granules, there appears 
reason to believe that union might still have occurred had more 
time been allowed. 

" After the foregoing observations, I no longer entertain the 
slightest doubt that wounds in articular cartilages are capable of 
perfect union by the formation of fibrous tissue out of the texture 
of the cut surfaces. The essential parts of the process appear to 
be the softening of the intercellular substance of the cartilage, 
the release of the nuclei of its cells, the formation of white 
fibrous tissue from the softened intercellular substance, and of 
nuclear fibres, by the elongation of the free nuclei. It does not 
appear necessary that the cells should become much enlarged 
or crowded with corpuscles, for the union may take place with- 
out any enlargement of- the cells, or increase in the number of 
their corpuscular contents ; these changes, therefore, though they 
contribute materially in some cases to the rapidity of completion 
of the process under consideration, are clearly not essential in 
any of its stages." , 

When the destructive process has removed the whole depth of, 
the cartilage to the bone, and when the laminal layer has been 
removed, the breach is repaired by an exudation from the, 
vessels of the bone, which, becoming converted into bony 
matter, occupies the afected part. 



MOBBID CONDITION OF CAETJLAGE. 223 

' When none of these results have taken place, the process 
of destruction is arrested and limited by a deposition into 
the bone of a peculiarly hard, calcareous material — the 
porcellaneous deposit — which fills up the cavity, and blocks 
the cancelli and canals of the bone, and by its smooth and 
polished surface makes up to some extent for the want of the 
cartilage. 

In old horses the cartilage of incrustation is exceedingly thin, 
and in some cases it wiU. be found converted by ossification 
into the above-mentioned ivory or porcellaneous deposit. This 
deposit is exceedingly dense, and derives its hardness from the 
Haversian canals being filled up by additional laminae. 

The depressions or cavities termed sulci, which are found in 
many close-fitting joints, as the elbow and true hock joints, 
must not be mistaken for a diseased condition. They are merely 
cavities for storing synovia. 

TRAUMATIC INFLAMMATION OF JOINTS. 

An open joint, when occasioned by puncture or incision, is 
not at first (if unassociated with fracture) attended by severe 
local or constitutional disturbance ; but at the end of a period 
varying from two to ten days pain comes on, and spreads over 
the joint, which soon presents a considerable amount of swelling 
and tension. The swelling is at first tense, but elastic ; how- 
ever, it soon becomes hard and unyielding, and accompanied 
by great constitutional disturbance, the pulse rising in frequency, 
becoming hard and wiry in its character, and the animal evincing 
acute and agonising pain by partial tremors and sweats upon 
his body. In facty all the constitutional symptoms indicate a 
state' of great irritability. The lameness is excessive. The 
animal is scarcely able to put its foot to the ground, whilst at 
the same time the pain causes it to keep it in an almost conr' 
tinual state of motion. An injury not, at first penetrating the 
joint may do so in the course of three or four days, by sloughing 
of the tissues around it, these having been destroyed but not 
removed by the violence of the injury. 

The discharge of synovia may be very trifling for some days 
after the accident ; but it gradually increases as the inflamma- 
tion a,dvances,. is thin in ita consistency, and mixed \yith flakes' 



224 DISEASES OF THE JOINTS. 

of lymph ; coagulates upoa the lips of the wound, and oozing 
through this there will be a thin watery discharge. There is 
exudation of a large quantity of lymph into the tissues surround- 
ing the joint, which becomes partly organized, forming a hard, 
firm swelling. The secretion from the wound is now unhealthy, 
purulent, or tinged with blood, whilst abscesses begin to form 
around the articulation. 

The fever and debility increase from day to day if the local 
symptoms be not arrested ; and finally the animal dies from the 
irritation. 

Condition of the Part. — From the admission of air into the 
synovial cavity, inflammation of the synovial membrane is 
excited; this extends into the extremities of the bones con- 
stituting the articulation; their cancelli become turgid, the 
Haversian canals enlarged ; the tissues contained within them 
form a disorganized mass, infiltrated with ichor ; absorption of 
the termination of the vascular part of the bone immediately 
contiguous to the non-vascular laminal layer ensues, by which 
it is detached (along with the cartilage covering it) from the 
extremity of the bone, and may be found floating in thin 
masses in the synovia within the joint. This process goes on 
simultaneously at the extremities of both the bones of the 
articulation, thus exposing their vascular interiors, from which 
loops or spongy granulations spring up luxuriantly. These 
unite with each other, and form vascular communications from 
the cancellated structure of one bone to that of the other, this 
being the first step in the process of internal anchylosis. From 
the blood-vessels of these new formations an exudate is formed, 
which is finally converted into bony matter. 

These granulations easily bleed, and when blood is seen in 
the synovial discharge, the veterinarian will understand that the 
laminal extremities of the bones have been removed, that their 
vascular interior is exposed, and that, if the joint affected be one 
of extensive motion, it will be useless to keep the animal longer 
in its misery. 

Treatment. — The treatment of open joint, to be successful, 
must have two objects in view : — \st. To promote the healing 
of the wound by the first intention, or by the adhesive pro- 
cess. 2d,. To prevent inflammation. For these purposes, both 
local and general measures are required, the local being the 



TRAUMATIC INFLAMMATION OF JOINTS. 225 

more important. It includes the apposition of the lips of the 
wound by pinning, or by suture, which must be either metallic 
or catgut. If there are any foreign bodies, such as dirt, gravel, 
or portions of disintegrated tissue in the wound, they must be 
carefully removed before its lips are brought together. To 
support the pin or suture, and to prevent the admission of air 
and germs into the wound, a thin paste made of spirit varnish and 
iodoform must be applied, by being painted on in successive 
layers with a camel's-hair pencil. The next thing to be done 
is to place the animal in slings as soon as possible. I consider 
this essential to the successful treatment of open joint, as it 
places the patient in the most favourable position for repose, 
and by preventing him from making even the attempt to lie 
down, does away with the danger of reopening the wound. 
All other local applications, by interfering with the healing 
process in the wound, are at this stage calculated to do 
harm. 

"Wounds upon or near articulations should never be meddled 
with, by any probing, for the purpose of discovering if there 
be fracture of the bones. If fracture exist, the lameness will be 
excessive from the first. A meddlesome interference with the 
probe has often caused open joint, when the original injury had 
not penetrated the synovial membrane. 

The constitutional treatment must be that calculated to lessen 
pain and irritation ; a small purgative, combined with opium, to 
be followed at intervals of four to six hours by doses of opium 
or of aconite ; and enemas of warm water, two or three times 
a day, v/Hl be beneficial, unloading the rectum, and enabling the 
animal to pass faeces without straining. 

If after the wound heal by these measures the infiammation 
of the joint continue, as in all probability it will, cold must be 
applied ; and the best method of doing this is by irrigation — 
that is, by allowing a continual stream of cold water to trickle 
over the surface of the joint. This is easily done by attaching 
a gutta-percha pipe to a tap, fastening the pipe to a convenient 
part of the slings, and carrying its free extremity on to the 
lame limb, and fixing it above the inflamed joint by means of 
a bandage. 

If this plan of treatment does not seem to succeed, a blister' 
must be used. 

Q 



226 DISEASES OF THK JOINTS. 

Such, then, is the. treatment when the lips of the wound admit or 
being brought into apposition, and when the practitioner has been 
called in before the advent of suppuration. If it be a lacerated 
wound, its lips must be brought together as well as possible, and 
retained in that position by the application of the styptic colloid. 

If these means are ineffective, if the injury has been inflicted for 
a longer period than a few hours, when inflammation is already 
established, and pus has commenced to be formed to plug 
up the wound at this stage would only cause the fluid accum- 
lated within the capsule of the joint to burst out at some other 
spot, but even in this stage much can be done by irrigating the 
joint and surrounding structures with a solution of corrosive 
sublimate— 1 to 500 parts of water— in order to destroy all 
germs which may have gained entrance, and then by covering 
the external wound with several layers of iodoform and varnish 
paste. If the discharges be profuse they must be allowed to 
escape, but much can be done to prevent the admission of 
atmospheric germs by the careful adjustment of boracic lint 
and light antiseptic bandages, through which the discharges will 
escape. If the discharges diminish and the bandages cause 
no inconvenience or irritation, they should not be removed until 
the cure has been completed. Every wound which has com- 
menced to suppurate must heal by granulations ; and the more 
perfect formation of these goes on in the deeper-seated parts of 
the wound — that is to say, that the healing is from within 
outwards. The plugging of the outer orifice while pus is being 
formed causes it to accumulate in the joint and surrounding 
structures, adds to the suffering of the animal, and in too many 
cases causes its death. 

An extended experience warrants me in recommending the 
application of a blister to the whole surface of the joint, as 
the most successful treatment that can be ado]ited if the wound 
has failed to heal by the primary or adhesive process. The blister 
acts by removing pain, limiting motion, exciting the formation 
of healthy granulations, and (as a result of the swelling it pro- 
duces) causing the approximation of the surfaces of the woiind. 

The coagulum of synovia which accumulates upon the wound 
should never be removed, as it prevents the admission of air and 
of germs into the joint, and thus limits the formation of pus. 



TRA.UMATIO INFLAMMATION OF JOINTS. 227 

Many cases when so treated make good recoveries ; but if 
ulceration of the cartilage and removal of the laminal ends of 
the hones occur (and this change will be indicated by haemorr- 
hage, or by increased pain and twitching movements of the 
limb), and if the articulation be one of extensive motion, the 
attendant will understand that the repair can only be by anchy- 
losis, and that anchylosis in such a joint will render the animal 
unfit for further use ; but if the joint be one of limited motion, 
the animal may become fit for slow work, even after the joint 
has been destroyed. The animal's shoes should be removed, 
provided this be done carefully, and before great lameness has 
manifested itself. If one of the lower articulations, particularly 
of the fore extremities, be the seat of the lesion, the animal can 
be made to stand in a tub of cold water, and the trouble of affix- 
ing the pipe for the purpose of irrigation be avoided. 

All cases of open joint require a long period of rest after 
the wound has healed ; and it is generally necessary to blister 
repeatedly, or even to fire, before the remains of the inflamma- 
tion excited in the bones and synovial membrane are finally 
removed. 

Several abscesses, some mere points of pus, others of a greater 
size, form in the exudate which has been formed outside of the 
cavity of the articidation during the progress of the disease. It 
may be considered necessary to open them surgically, if they 
cause increased pain. It may be well to do so ; but if they are 
mere accumulations without pain, the cautious surgeon will not 
interfere, rather allowing them to burst spontaneously. 

The horse should be kept in the slings until he is able to bear 
a moderate amount of weight upon the affected limb. 

During the early period of the disease, the food must be spare, 
light, and cooling ; but when the fever has abated, it must be 
of the most nourishing kind, in order to compensate for the 
great waste of tissue and emaciation which are so characteristic 
of open joint. 



DROPSY OF THE JOINTS, OK HYDKOPS ABTIGULORUM, 

Is a morbid condition, with or without inflammation, as in bog- 
spavin, and its analogues termed wind-galls. In this affection 
the synovia is more abundant and serous than is natural, and 



228 DISEASES OF THE JOINTS. 

distends whole joints or bursa. There is seldom much pain 
or lameness, because the ligamentous and other textures have 
been yielding gi-aduaUy, and are but passively distended by the 
fluid. The quantity of the secretion is liable to variations, dis- 
appearing more or less upon exercise, and accumulating after a 
short rest. During long periods of rest, however, the accumula- 
tions may disappear, and appear again when the animal is put 
to work. 

Young growing cart-horses are very subject to the formation of 
these fluid enlargements, more especially about the hocks. When 
they are full grown, however, their joints may become quite fine. 

The treatment most appropriate is the application of blisters 
and pressure ; but this will be again referred to under the head 
of Lameness. 



ANCHYLOSIS, OE THE STIFFENING OF THE JOINTS. 

There are several forms of anchylosis : — 1st. Osseous, or true ; 
2d. Fibrous ; 3d. Ligamentous ; 4:th. Spurious. 

1st. The true anchylosis may be general and complete at every 
part of the joint, as in some bone-spavins and true riag-bones, 
where all trace of the articulation has been lost, and the opposing 
bones so firmly united as to appear as one bone. Before 
this can happen, the articular cartilages and laminal layers of 
the opposing bones must be removed by an ulcerative absorp- 
tion, and an exudate thrown out from their cancellated structure ; 
which, becoming organized into bony matter, cements the bones 
together. This is the natural termination and cure of such 
causes of lameness, and it is usually accompanied by a deposition 
of bone upon the outside of the affected joint, which aids in the 
completion of the anchylosis. 

2d. The fibrous. — The opposing surface of the bones may be 
united by fibrous tissue. As a rule, however, this is only found 
during the earlier stages of true anchylosis. 

3d. The ligaments become rigid to such an extent as to make 
a joint more or less stiff and immoveable, whilst the articular 
surfaces of the bones remain healthy. Stiff joints of old horses 
are examples of this. 

ith. The spurious is that which depends on deposition in tex- 
tures external to the joint, uniting the various structures to each 



ANCHYLOSIS. 229 

otiier. This form is always present to some extent after acute 
inflammation of a joint ; and appears around the lower joints of 
a limh which is mal-formed by contraction of the flexor tendon, 
or rupture of the suspensory ligament, as shown in Photo-litho- 
graph, Plate III., Fig. 6. This form can be removed by forcible 
extension of the articulation, after division of the contracted 
tendon. It is also present to some extent after open joint suc- 
cessfully treated, and disappears gradually by absorption when 
the joint is brought into use. Its removal may be accelerated 
by repeated applications of iodine to the skin. 



AJSrCHYLOSIS, OE THE STIFFENING OF THE JOINTS. 



EXPLANATION OF PHOTO-LITHOGEAPH, PLATE IIL 

1. Anchylosis of Shotildee-Joint. 

2. Incipient Ai^chylosis op Elbow-Joint, shelving removal of 
cartilage and lamiaal layer of the bone, on extremity of humerus. . 

3. 4. and 5. show Anchylosis of the Carpal, and First and 
Second Phalangeal Articulations. 

6. Anchylosis and Destruction of all the Phalangeal Articula- 
tions in an old-standin<' case of " Break-down." 




plaj::e m 







CHAPTER XIT. 

LAMENESS. 

DIAGNOSIS DEFINITION SIGNS CAUSES CONGENITAL MUSCULAR 

ATONY EMBOLI METHODS OF EXAMINATION SPRAINS STRAINS 

OF PSO^ MUSCLES CHOREA STRINGHALT SHIVERING. 

Having entered into the pathology of the Diseases of Bones and 
Articulations, I shall now consider the question which may be 
looked upon as being the one to which the greatest importance 
may be attached, namely, that of Lameness. 

Diagnosis of Lameness. — The readiness with which some men 
are able to detect lameness seems to be an instinctive gift. 01 
such was Professor Dick, who could, at a glance, even when a 
horse had been moved but a few yards, tell the seat and the 
cause from which he was lame. But whilst this is so easy a 
matter to some, to others it is a task of great difficulty, requiring 
long-continued practical study and observation. There are, how- 
ever, cases where the most experienced are at a loss, and where 
even the most skilful differ in opinion. To the young man 
entering upon the duties of his profession, this matter is apt 
to cause many anxious thoughts and uneasy moments, as a 
mistake at this period may interfere very materially with his 
success in life. To such I would say, JSTever express a de- 
cided opinion until you are thoroughly satisfied as to its 
correctness. 

The first point to be determined is the limb in which the 
patient is lame. This may seem an easy matter, but in reality 
it is attended with no little difficulty. Thus, a mistake may be 
made by expressing an opinion that the lameness is in the 
hind le-T, when in reality it is in the fore, and vice versa. This 



■||» nes 



232 LAMENESS. 

error has been so often committed, that the peculiarity of gait 
which has led to it has been called "cross-lameness." For 
example, a horse lame in the off fore leg is trotted from the 
observer ; he seems as if he were lame in the near hind, for the 
quarter seems to ascend and descend. But when the animal 
■is trotted towards the observer, it will be seen that the irregu- 
lar motion of the hind quarters depends upon the elevation 
and dropping of the head and body ; and that the lameness in 
reality is in the fore, and not the hind limb. An opinion must 
not be given before the horse has been trotted from, and towards 
the observer. Of course there are many cases where lameness 
is so apparent that such an examination is quite uncalled for ; 
at the same time, there are many other cases so slight in degree 
as to require the most rigid scrutiny. 

The next difficulty is the detection of lameness when it is 
situated in both fore feet. When such is the case, an animal 
may seem to go as if sound. Advantage has been taken of this 
by low horse-dealers, who, when they have a horse lame in one 
fore foot, make him lame in the other also. This is by them 
technically termed " Beaning," and consists in placing a small 
piece of iron tightly under the shoe of the sound foot, whicli 
produces so much pain as to cause lameness. A more refined 
method has latterly come into vogue, that of paring the toe ot 
the sound foot nearly to the quick, and so adapting the shoe 
as to press upon the weakened spot. 

A horse lame in both feet, although he may not drop in his 
gait, will be short in action; will go, as it has been more 
forcibly than elegantly expressed, "like a cat on hot bricks." 
Each foot is carefully put to the ground, and quickly lifted up 
again, while at the same time there is a rolling motion of the 
body. In other cases he may exhibit the lameness in one foot 
as he goes from, and in the other as he approaches the observer. 
Such cases are very confusing, and require all the veterinary 
surgeon's discriminative powers. Care must be taken not to 
confound peculiarity of action with lameness. For example, a 
horse, especially a young one, may appear lame in the near 
fore foot, if led with a short rein, and his head pulled to one 
side, or when he is first bitted. This is called " bridle lame- 
ness ;" it disappears when the animal is run in a slack rein. 
horses which are habitually exercised in a rincf, or 



SIGi^S OF LAMENESS. 233 

.round a cii'cle, invariably seem lame upon the fore limb nearest 
the centre of the ring. When the lameness is in both hind 
Umbs, the difficulty of diagnosis is not so great, as the animal 
is both stiff and lame ; but mere stiffness must be distinguished 
from lameness, although it is often confounded with it. IsTo 
doubt a stiff horse is an unsound horse ; but he may be very 
useful for slow work, and at a suitable price. Mere stiffness 
may indicate age or fatigue, and often passes away after a little 
exercise; but lameness is indicative of actual pain or disease, 
and although it may pass off with exercise, still it must not be 
confounded with stiffness. 

There are some forms of lameness which are apparent in the 
■stable only, the movements caused by bringing the patients 
out of the stable being sufficient to produce the total disappear- 
ance of the lameness. Such being the case, the examiner 
should see the horse in the stable as well as out of it. 

The manifestation of lameness by the animal is shown in 
two ways: — 1st. During repose; 2d. During movement. In 
some cases, the appearance, or expression, is much more pal- 
pable while the animal is standing still, as in many foot lame- 
nesses. For example, a horse will continually point, or even 
elevate, the foot which is suffering pain ; if both feet, each foot 
alternately will be pointed or elevated. But if he is made to 
move, the extent of the lameness does not seem equivalent 
to the amoimt of pain so expressed. In other eases, the patient 
wiU stand perfectly iirm, although in the great majority of cases 
the pastern of the lame limb is more upright than that of the 
sound one, as if he feared to put as much weight upon it ; but 
when made to move, he will immediately exhibit the lameness. 
Again, many cases are seen in practice where the patients come 
out of the stable sound, but when they have performed some 
work or exercise, lameness becomes manifest. Others, again, 
leave the stable very lame, and become freer in their action 
when they have been warmed with exercise. Such cases are 
apt to deceive; therefore the veterinary surgeon should take 
every precaution against being taken unawares. Some horses 
exhibit their lameness when they " turn round." They may go 
weR enough if led straight to or from the observer ; but when 
sharply turned round, they at once manifest their unsoundness ; 
and when an examiner as to soundness finds a man turn his 



234 LAMENESS. 

horse " tarefuUy round/' he should watch narrowly, and com- 
pel him to be turned quickly. Slight chorea or stringhalt 
is seldom detected except during the turn, and I have seen 
cases where it was manifested when the animal was turned one 
way only. 

In other cases lameness may exist in two or more limbs, 
but not equally; and when so complicated, the animal may 
endeavour to save the lame limbs by throwing his weight from 
them in a manner so peculiar that it requires great care to 
distinguish the true nature of the case, and to form a correct 
opinion. 

Again, there are some horses which walk down hill in so 
peculiar a manner, that they may be supposed to be lame. 
This kind of walk has been termed a " three-cornered walk." 
The animal sways from side to side most awkwardly ; his hind 
quarters being turned to the one side or the other, going forwards 
broadside-on, similar to an animal going down hill with a heavy 
load behind him. Young horses, when being broken-in, should 
be corrected of this fault, as it is most unsightly ; and to see a 
rider on a horse of this kind reminds one very forcibly of Don 
Quixote and Rosinante. 

A touch of the whip or spur will cause the horse to improve 
his paces, and at once show that it is not lameness, but laziness, 
from which he is suffering. 

The signs of lameness manifested during repose are very 
important, and sometimes diagnostic. A horse suffering acute 
pain in one of his legs will, if it be a fore limb, point the foot : 
by pointing is meant the extension of one limb in advance 
of its fellow. This is done for the purpose of relieving pain, 
and is performed by throwing the flexors into a state of relaxa- 
tion, and removing any tension or pressure from the painful 
part. This pointing does not apply to every lameness in a fore 
limb, nor particularly to any cause of it, for in some rare in- 
stances a horse may be lame in both fore feet from chronic 
navicular disease, yet never point. 

The pointing of elbow lameness is characteristic, the fore 
arm being extended, the knee in a state of flexion, and the foot 
perhaps upon a level with or posterior to its fellow. In severe 
shoulder-lameness, the pointing, if it can be called such, is 
backwards, the limb relaxed, the knee bent, and the foot pos- 



SIGNS OF LAMENESS. 235 

tei'ior to its fellow ; sometimes the toe only touching the ground ; 
the whole of the limb semi-pendulous, consequent upon the 
inability of the muscles to elevate and bring it forward without 
pain ; as a man fails to lift his arm when his shoulder is injured 
or diseased. 

If the lameness be in a hiud limb, the patient may stand with 
it either flexed, "knuckling over" at the fetlock, or with the 
foot off the ground altogether. When he stands with his lame 
(hind) leg in advance of the sound one, the position generally 
indicates disease in or below the hock. 

A horse with acute pain in the fore feet will stand with his 
hind ones advanced beneath the body, resting first one fore foot 
and then the other, and every time he moves will rear up his 
head, and stretch out his neck in expression of the pain he 
suffers ; hut should the pain be in both hind feet, he will stand 
with his fore feet beneath his chest and towards the central line 
of gravity ; his body pushed forwards, and head hung down, in 
order to remove the weight as far as possible from the seat of 
pain. He wUl first ease one hind foot, and then the other, 
breathing heavily, and showing other signs of acute pain. Pain 
in both hiud feet often interferes with the act of urination, by 
preventing that stretching of the body which is so characteristic 
of that act in the horse. In such cases the poor patient will 
endeavour to stretch himself, will elevate the tail, but with a 
groan quickly assume his former posture, and suddenly "pick 
up " the feet alternately. From this fact it is often supposed 
that a horse suffering acute pain in the hind feet has some disease 
of the urinary organs. 

The practitioner having satisfied himself which leg an animal 
is lame in, he must now endeavour to find out the seat of its 
cause. The late Professor Dick taught us to cause the shoe 
to be removed, and the foot examined in every case of lame- 
ness. This is a good rule to be followed, especially by young 
practitioners. He used to relate a case (showing the importance 
of this rule) where the os suffraginis was fractured. His great 
skill in lameness led him to think, upon examination, that the 
fracture was not the onl]/ cause of the lameness; he had the 
shoe removed, and discovered a wound from a nail in the foot, 
containing purulent matter. The fact of the horse being injured 
in the foot explained the cause of the fracture,— the animal, on 



•Job LAMENESS. 

account of the pain, having trod unevenly, prevented the equal 
distribution of his weight, and caused the fracture. The Pro- 
fessor had the foot attended to, as well as the fracture, and the 
patient made a good recovery. Now, had he been satisfied, as 
the majority of men would have been, that the fracture was the 
only cause, the purulent matter confined in the foot would have 
forced its way out at the coronet, a high degree of fever would 
have been excited, the case much complicated, and the Professor 
accused of mal-treatment. 

After duly examining the foot, and being satisfied that the 
lameness is not there, the practitioner must endeavour to find 
out where it is ; but before considering the various lamenesses 
in detail, we must refer to the definition of the word and the 
variety of its causes. 

The word lame, according to Percivall, is from the Anglo- 
Saxon lam, weak; the terms lame and weak are synonymous 
in some parts of England ; thus it is a common expression 
to hear, " that is a lame story," for a weak story ; or a " lame 
sermon," for a poor, weak sermon ; and more commonly, a " lame 
excuse." 

The same writer defines it to be — " The manifestation in the 
act of progression, by one or more of the limbs, of pain, weakness, 
inability, or impediment." 

Tills definition is very near the mark, but I think it would 
read better as follows : — A manifestation by one or more of the 
limbs, of pain, weakness, inability, or impediment; the act of 
progression not being necessary to the manifestation of such. 
Percivall, however, must always be looked upon as a great 
authority, as he seems to have been a practical man in most 
matters, as well as an elegant writer. 

Lameness is not of itself a disease, but a sign of it. It is the 
expression of pain or inability, the result of disease, accident, or 
malformation in the limb or limbs by which it is manifested. 
It may, however, arise from disease apart from the limbs, as from 
injury to or diseases of the spinal cord or nerves, from cerebral 
disease, and occasionally disease of the liver. It may exist for 
a short time independent of disease — a mere expression of pain 
without disease, as from a stone in the foot, or a badly-fitting 
shoe ; but if these caases of pain exist for any length of time, 
inflammation is sure to follow. Disease much oftener exists 



CAUSES OF LAMENESS. 237 

in a limb without lameness than lameness without disease. 
Tlius, a horse may have a wound, idcer, bony deposit, or a 
tumour, without evincing lameness. From these particulars we 
may argue that lameness is never present without pain, although 
PercivaU asserts that inability, in the absence of pain, will be 
found as a cause of lameness, and he says — " Dislocation of the 
patella occasions no pain, and yet the horse is too lame even to 
move. The partial or complete anchylosis of a joint may cease 
to be attended with pain, and yet there may be permanent and 
irremoveable lameness." I think we may safely take exception 
to these conclusions, as they are not borne out by every-day 
experience. 

Complete anchylosis may exist without pain, and yet the 
patient is lame ; but it will be found that such anchylosis exists 
in some joint of extensive motion, and prevents flexion and ex- 
tension in the whole limb. 

Pain, then, may be generally said to be the common cause of 
lameness. Tlie patient feels the pain either when it moves the 
limb, or when it bears weight or presses upon it. During motion 
the patient endeavours to avoid throwing pressure upon the lame 
limb, by treading lightly or stepping short, and by removing 
weight as far from the seat of pain as it possibly can, not only 
by using the lame limb in a maimer best calculated for this 
purpose — as by treading on the heels when the pain is in the 
anterior part of a limb or foot, and upon the toes when in the 
posterior part — but also by throwing the weight /ram the lame 
limb as much as it possibly can. 

Weakness of the limbs may cause lameness and inability to 
perform the function of progression properly. A characteristic 
example of this has been described by Mr. George Armatage, 
under the title of " Congenital Muscular Atony," or a want of 
development of muscular fibre in the extensor muscles of the 
fore arm of foals. In this form of lameness the animal stands 
almost upon the front part of the fetlock-joints ; the flexor 
muscles healthy, fully developed, and having no antagonistic 
power opposed to them, in consequence of the arrested develop- 
ment of the extensors, draw up the limbs posteriorly ; the heel 
of the foot and the fetlock pad being in close contact, the little 
animal beiiig at the same time almost unable to move. I have 
found this kind of lameness occurring at any time during the ; 



238 LAMENESS. 

first year of tlie animal's life, and it may not always be viewed 
as " congenital." Grazing on very bare pastures is apt to cause 
it, more especially if the foal be short in the neck, or when so 
formed that he has to bend over on his fore Umbs considerably 
before he is able to obtain his bite of grass. Continuance in this 
position for a long time each day causes a weakening and arrest- 
ment of development of the extensor muscles, whilst at the same 
time the flexors called into action are excited to increased 
development. We have thus, concomitantly, atrophy of the 
extensors and hypertrophy of the flexors. 

Mr. Armatage recommends the continued application of 
mild blisters to the anterior region of the arm, to excite the 
exudation of plastic material and the development of the 
exudate into muscular fibre, and, by bringing more blood to 
the part, to increase its tone and power, and elevate its func- 
tional activity. 

A horse may be lame from excess of tonicity in the muscles 
of a limb, accompanied by much pain, as in cramp, which renders 
him for the time being dead lame. 

In other cases lameness may be due to disease in the blood- 
vessels of the limb or their parent trunks. For example, most 
extreme lameness is manifested in limbs when their "arteries 
of supply " become plugged by thrombi. Cases of this kind have 
occurred in my own practice, where the horse became dread- 
fully lame, and exhibited symptoms of great agony when- 
ever put to work, while in the stable no signs of pain were 
present ; but when he had worked in the carriage for about 500 
yards, he would show signs of weakness in one hind limb, 
commence to sweat, and finally become immoveable with pain. 
After a short period of repose, these symptoms would dis- 
appear, but appear again if any attempt was made to work 
him. 

In addition to pain and lameness, the limb was deathly cold 
to the touch, and upon a post mortem examination being made, 
the external iliac artery of that side was found nearly oblite- 
rated by a deposition of fibrine. 

In the detection of the lame limb, the following rules may be 
laid down for the guidance of the young practitioner : — ^Whcn 
the lame limb comes to the ground during progression the 
animal suddenly elevates that side of his body and drops the 



METHODS OF EXAMINATION. 239 

other side. If the lameness be in a fore limb the head as well 
as the fore part of the trunk is raised from the lame and dropped 
upon the sound limb. This is called " nodding." If the lame- 
ness be in a hind limb, the quarter of the same side will be ele- 
vated and that of the sound side thrown forwards and downwards 
by a jerldng motion ; the head being moderately steady if the 
pain be not great, and jerked if there be acute agony. It is 
only by carefully noting these facts that we are able to detect 
the limb in which an animal may be lame. 

The signs indicative of the seat of lameness are of two 
kinds : — (1.) Those manifested by action ; and (2.) Those dis- 
coverable by examination, while the animal is in a state of 
rest. In some instances the latter are alone sufficient to indi- 
cate the seat and nature of the disease, but the lameness must 
be of a severe character, manifested by "pointing," standing 
with the lame limb flexed, or even completely elevated from 
the ground; or, as in laminitis, with the unaffected feet and 
limbs placed as much under the body as possible. 

In the majority of cases, however, it is necessary to cause 
the patient to perform some movement ; and it is agreed by all 
practical men that the slow trot is the best pace. , A horse may 
walk lame, but if such be the case, he must be very lame. 
There are cases, however, as in " slight splint lameness," where 
it is necessary to urge the animal to a sharp trot before any 
deviation from the normal gait can be distinguished. 

The following rules may be useful for the guidance of young 
practitioners : — The horse should be led out of the stable in a 
snaffle bridle, with the rein over the head. Let the man who 
leads him be ordered to hold the rein at about eighteen inches 
from the mouth, and let there be no holding up of the animal's 
head by a tight curb or rein, to prevent "nodding;" but, at 
the same time, the rein must not be too long, for if this be the 
case, a spirited animal may turn round so far as to kick the 
man with his hind foot. The horse should be trotted im- 
mediately after he is taken out ; and for this reason, that any 
very slight lameness may disappear if he be walked any dis- 
tance. Many low dealers wiQ knock a horse about in the 
stall to remove such lameness. This should be looked to in 
every suspicious case. If the horse be frisky, he must be cooled 
down and very carefully led, in order that the examiner may 



240 LAMENESS. 

have a fair chance. It has been already stated that it is 
necessary to make the horse run both from and to the 
observer, and it may be necessary to do this repeatedly ; but if 
an examiner cannot determine the existence in two or three 
minutes, it is better to put the horse up again, as the exercise 
has a tendency to decrease, or even to remove the lameness. In 
some very slight cases, it may be necessary to place a rider on 
the horse, as the weight upon the back will cause the mani- 
festation of the lameness. . As a rule, however, it is better not 
to do this, especially if the animal be a spirited one. 

There are some lamenesses which are only manifested after 
sharp work, and in such cases it is necessary to give the horse 
half-an-hour's trot or gallop, tying him afterwards in a stall 
until he becomes cool. When taken out of the stable and 
trotted after such a test, lameness, if in existence, will most 
assuredly be detectable. Some veterinary surgeons do this 
with every horse they examine ; but it is quite needless in 
ordinary cases, and it is only when some suspicion exists that 
such a test is necessary, such as badly-formed hocks, splints 
near the knee, or some alteration of structure in any part of 
the limb, or in cases where there is " pointing " while at rest, 
or where the disease is very slight. 

The gait only is sometimes sufficient to determine the seat 
of lameness, and in some cases it is the only guide ; but it is 
a good rule, and one that should never be neglected, to examine ^ 
the lame limb while the animal is in a state of rest. 

By the latter method we discover lameness by positive and 
negative signs. For example, if there be heat, pain, or swelling 
in any part of the limb, discoverable by manipulation, the 
evidence is positive that the cause is in such a part; but if, 
on the other hand, there be neither pain, heat, nor swelling 
in the limb, nothing in the superficial parts of the foot to 
account for it, we must conclude that it is deep-seated in the 
foot, or in a part thickly clothed by healthy tissues, and we 
must arrive at a conclusion by negative evidence, assisted by 
peculiarities of gait. 

Lameness may be caused by a strain of a ligament, muscular 
tissue, tendon, by fractures, diseased bones, cartilage, or fibro- 
cartUage, morbid conditions of the skin ; neuromatous and other 
tumours; plugging of arteries; accidents, as "pricks" in shoe- 



CAUSES OF LAMENESS. 241 > 

ing, "treads," wounds, ulcers, rheumatism, and reflex nervous 
action, as in diseased liver. 



A SPRAIN, OE STRAIN, 

Is violence inflicted upon any soft structure, with extension, and 
often rupture of its fibres. Professor Dick was of opinion that 
there was always rupture of the fibres in a sprained tendon or 
ligament. But I think that the condition which we term strain, 
may arise from repeated extension or slight stretching, without 
the fibres being at first ruptured at all; and that an altered, 
nutrition is so produced, which leads on to inflammation of the 
part, with interfibrillar exudation, and finally to the softening of 
some portion of the fibres, by which they lose their toughness, 
and become broken across. A very slight strain may be a mere 
bruise, with ecchymosis ; whereas violent and great extension 
may rupture the whole structure of a part. 

Extension is not always the cause of a strain, as a muscle may 
be injured by the opposite condition, namely, violent contrac- 
tions ; its fibres and their thecee broken across their long axes ; or 
its tendinous fibres torn from their attachments at either or both 
of its extremities. 

Strains may be confined to the thecae or sheaths only, but 
these are of but little importance compared with injury to the 
ligaments or tendons themselves. It has been already stated 
that synovitis may arise from strain of a ligament, by the inflam- 
mation extending to the small synovial surface which is found 
on most " binding ligaments." 

Muscular strains are found in various parts of the trunk and 
limbs. Thus, a horse may be strained in the neck, as a result 
of a fan upon the head. If the fall be very severe, the strain 
may be complicated with severe injury to the spinal cord, or 
with fracture of the vertebrae, causing perhaps the sudden death 
of the animal. 

The muscles of the dorsal region may be sprained by the hind 
feet slipping backwards. When a muscle is strained the injury is 
. succeeded by pain, swelling, heat, and loss of function. An in- 
flamed muscle can no longer contract ; hence, in some strains, 
the symptoms resemble those of paralysis. 

This swelling of an inflamed muscle is very often succeeded 



242 LAMENESS. 

by loss of substance (atrophy), and sometimes by fatty degene- 
ration of its fibres, whereby they lose their red fleshy appear- 
ance, and assume that of whitish threads of fat. When micro- 
scopically examined, the sarcous elements — the real contractile 
tissue within the sarcolemma — is replaced by glistening oil 
particles, so that the functional power is completely destroyed. 
If the whole muscle be involved, its contractile power no longer 
exists ; and this loss of power will vary according to the extent 
of the muscular structure involved in the primary lesion. 

Atrophy of the fibrillae, and consequent fatty degeneration 
of their contents, is often due to pressure by an inflammatory 
exudate formed in the spaces of their connecting areolar tissue ; 
and it is important, practically, to remember this, for the reason 
that the sooner an exudate can be removed, the less chance 
there is of degenerative changes taking place in the true mus- 
ciilar elements. 

The changes that occur in inflammation of muscular tissue, 
whether arising from strain or other causes, may be briefly de- 
scribed thus: — 1st. Swelling from congestion and exudation; 
2d. Atrophy, from the pressure of the exudate upon the muscu- 
lar fibrniae, and from loss of function ; 3d. Patty degeneration of 
the sarcous elements, and permanent loss of contractility. 

Treatment. — Eepose; soothing applications, succeeded by 
slight, and afterwards stronger irritants. Purgatives and cool- 
ing diet at first, followed by good nursing. 



STRAIN OF THE PSO^E MUSCLES. 

Much confusio'n prevails among veterinary surgeons as to the 
proper diagnosis of this injury, some classifying all cases of in- 
ability, or paralysis of the hind limbs, unless broken back can be 
detected, as sprain of the psoas muscles ; whilst others deny the 
existence of such an injury at all. 

Sprain of the psote muscles simulates paralysis, broken back, 
and that mysterious disease which has been erroneously termed 
hysteria by Mr. Haycock, — a disease which, in reality, is due to 
the presence of a large amount of effete materials, especiady urea, 
in the circulation, and which may be termed Azotueia. 

The psoas muscles — magnus and parvus — are, along with the 
iliacus, sartorius, &c., situated within the pelvic and sub-lumbar 



STRAIN OF PSO^ MUSCLES. 243 

regions, originating at the heads of the last rihs and last dorsal 
vertebra), extending in a backward direction under the bodies of 
the lumbar vertebra", to the ilio-pectineal eminence on the brim 
of the pelvis, and the internal trochanter of the femur. Their 
action is to bend the haunch upon the pelvis, to draw it forward 
in progression, or while the hind quarters are stationary and 
fixed points, their action produces that appearance called 
" reached back." 

It is important to remember the action of these muscles, 
for when injured they cease to act, and the haunch wiU be 
thrown into the opposite condition of "roached back;" and 
I'rom this circumstance the injury may be readily distinguished 
from azoturia. 

Strain of these muscles is caused by injury, such as " being 
cast in the stall," or by any other accident capable of producing 
violent extension of them ; hence arises the difficulty of deter- 
mining between it and " broken back." It may, however, be 
distinguished from the paralysis of broken back by the power of 
flexing and extending the hmbs being still retained by the ani- 
mal whilst it is lying down ; there may be inability to rise from 
the ground, as the psose muscles assist very materially in that 
operation ; but when raised by means of slings from the recum- 
bent position, and when the hind feet are firmly placed upon 
the ground, the horse is able to stand moderately well, and 
command the movements of the limbs to some extent, although 
there is always a tendency to knuckling over at the fetlock- 
joints. 

The muscles of one side may be injured ; in such a case the 
loss of power is limited to one side only. 

If the injury be not sufficiently severe to destroy the power 
of rising, it will be seen that, when the horse is made to walk, he 
drags his limbs or trails them to some extent. There is scarcely 
any elevation of the feet or flexion of the joints, and a great 
tendency is shown to knuckle over at every step. 

Examination per rectum will reveal heat, tenderness, and 
swelling under the spine ; and in the majority of cases that 
have come under my observation, external swelling around the 
rectum and perinseum, or vagina, if the patient be a mare, will 
make its appearance in the course of a few hours after the 
accident. 



244 LAMENESS. 

The acute inflammation is generally succeeded by a condi- 
tion of atrophy, and for some time afterwards the animal will 
show signs of weakness and inability ; but these will pass, away 
as the muscles regain their power and tone. 

Treatment. — Eest in the slings; enemas, to act as internal 
fomentations ; aperients, and febrifuges if fever be present. 
In cases where the appetite is not much impaired, and but 
little or no fever supervenes upon the injury, the administra- 
tion of medicine should be withheld. Fomentations must be 
applied to the loins and perinseal region ; and after the first 
few days, mild external stimulants, as weak ammonia liniment, 
also good food and careful tending. It may be laid down as a 
general principle that slings do harm when the animal is unable 
to stand in them, and if both fetlocks knuckle forwards, and the 
whole weight of the patient be thrown upon the abdomen, 
slings should not be used; but should he be able to stand 
when the feet are implanted on the ground, the slings are 
very useful. After some time has elapsed, and when the patient 
appears not to make the desired progress towards recovery, a 
good blister to the loins and quarters will be very beneficial, and 
will hasten the development of muscular tissue. If the season 
be favourable, a run at grass in some quiet place will complete 
the cure. 

Muscles are liable to become deranged in their function either 
by an exaltation or depression of their contractile power, and 
these conditions are generally exhibited in the muscles of the 
lumbar, gluteal, and femoral regions. 

The causes of these aberrations of function are often very 
obscure, and seldom demonstrable. It has been already pointed 
out that diseases of the spinal bones are present during life 
without any very decided external manifestations; and from 
this it may be inferred that such diseases as " stringhalt," 
shivering, or that form of partial paralysis vulgarily termed 
" jinked-back," as well as that peculiarly obscure nervo-musoular 
disease called by French veterinary writers " immobility," and 
by English horsemen " German horses," are aU probably due to 
some disease of the sensory track of the spinal cord, similar to 
the " loco-motor ataxia " of the human patient, which is thus 
described by Aitken in his Science and Practice of Medicine, 
1866 : — " In the erect posture the muscles may sustain a heavy 



STEAIN OP PSOiE MUSCLES. 245 

weight, and general paralysis does not supervene for months or 
even years. There is then a gradual and progressive loss of the 
power of co-ordination in the acts of volition. An awkward 
unsteady gait is the earliest indication of such progressive para- 
lysis. At first the feet are moved in a slatternly manner, the 
heels lounging on the ground, and then, as the disease advances, 
they are thrown involuntarily to the right or left without pur- 
pose, and without the power of restraining their irregular move- 
ments. The act of turning round is performed with great 
difficulty. ... If the patient is put on his legs with his eyes 
shut, and his feet close together, it is seen that, although he has 
the muscular power he has not the muscular sensibility to pre- 
serve his body from falling, or to guide him in taking even a 
few steps forward with his eyes closed. He will reel and tumble 
about like a drunken man." 

Functional irregularity of muscular action may arise from 
fatty degeneration of the muscles, without any disease being 
found in the nerves or nervous centres. 



CHOREA. 

Definition. — An irregular convulsive clonic action of the volun- 
tary muscles, confined generally in the horse to the posterior 
extremities — constituting " stringhalt," and in the dog as a sequel 
to distemper — to the anterior ones, neck, and face, by which they 
are withdrawn from the control of volition, more especially 
during sleep. 

Many pathological views are entertained regarding this disease. 
By some it is regarded as entirely functional, and independent of 
organic change. By others it is held that it is due, at least in 
some eases, to some disease of the blood, the precise nature of 
which is as yet unknown, and that it may be associated with 
some diseases, as rheumatism and diseases of the heart. 

Professor Dick was of opinion that it was due to the pre- 
sence of tumours in the lateral ventricles of the brain, and 
supported his views by a fost mortem, proof. But tumours in 
the ventricles may be present without chorea, and chorea is 
very often present without such tumours. Other writers have 
traced its origin to a hypertrophied condition of the nerves 
given off from the lumbar plexus, to the pressure of some 



246 LAMENESS. 

exostoses on a nerve, and to paralysis of the muscles antago- 
nistic to those affected with the spasm. In one case which fell 
under my notice, melanosis within the spinal canal was the cause 
of chorea ; but the spasm (clonic, or rapidly alternating contrac- 
tions and relaxations) of chorea is not a phenomenon of persis- 
tent spinal irritation, while tonic spasm is a mark of such a 
condition. 

Chorea may be divided into partial, as in stringhalt in the 
horse, and general, as seen occasionally in dogs. 

Stringhalt may be defined to be an involuntary convulsive 
motion of the muscles, generally those of one or both hind legs, 
but occasionally it is seen in the fore legs also. 

The limb or limbs affected are convulsively elevated from 
the ground, and brought down again with more than natural 
force. It is not always to be noticed at every step the horse 
takes. He may go several paces, as many as twenty, without 
exhibiting any signs of stringhalt ; then, aU at once, the limb 
or Hmbs will be suddenly elevated from the ground with a 
peculiarly sharp sudden jerk. It is necessary sometimes to turn 
the animal round from right to left, and from left to right, in 
order to make him show any signs of stringhalt, the symptoms 
of the disease being exhibited as he turns one way only. It is 
generally developed slowly, but I have seen very aggravated 
cases come on in one night, and as age advances it always 
becomes worse. It should be viewed as an unsoundness, and 
as a cause of depreciation of the animal's value. In two horses 
which had suffered from very violent stringhalt, the post mortem 
examination revealed exostoses on the shaft of the ilium, 
involving the great sciatic nerves. I think its cause is sometimes 
peripheral, as when a bone-spavin presses upon the nerves of 
the hock. The stringhalt then is due to reflex nervous action. 

In grey horses, stringhalt is occasionally due to a deposition 
of melanotic material in the sheath of the great crural nerves. I 
am inclined to the opinion that chronic stringhalt, or that form of 
it not dependent on rheumatism, arises from a congested condition 
of the nerves and their sheaths, and that there is always a tendency 
to the occurrence of neuritis from causes that would otherwise 
have no effect upon the nervous system. This view is supported 
by the fact that injuries to the feet, or any part of the limbs 
affected with stringhalt, are very prone to be succeeded by increase 
of the spasm, by much nervous excitement, and by tetanus. 



CHOREA. 247 " 

Some horses affected witli stringhalt, when injured in the 
feet, become almost unmanageable from the extent of the spasm; 
they are soon exhausted by the expenditure of nervous and 
muscular force, and the mortality from such injuries is much 
greater than in horses free from stringhalt. 

There is no treatment in chronic stringhalt. I have divided 
the tibial nerves when it has been associated with bone-spavin. 
In this case it was confined to one leg only, and to a fearful ex- 
tent, the foot being caught up with extreme rapidity, and brought 
down with great violence, insomuch that the shoe was repeatedly 
broken by the violence of the concussion. There was a bone- 
spavin on the hock, with considerable heat and tenderness. 
After trying various remedies upon the hock without good 
result, I divided the tibial nerves ; but the animal derived no 
benefit from the operation. In aggravated cases the limbs are 
adducted, the foot thrown outwards, as well as elevated, during 
the act of progression. But where the symptoms are aggravated 
from any cause — such as an injury, common cold, or other source 
of febrile disturbance — the severity of the spasmodic action may 
be much modified by removal of the cause of excitement, and by 
a cathartic, belladonna, or the bromide of potassium, in suitable 
doses. Hard work will very often increase stringhalt to such an 
extent as to call for medical treatment. In the rheumatic form 
the treatment for rheumatism is to be prescribed. In Australia 
"stringhalt" is becoming serious, but its cause does not seem 
to be yet discovered. 

IMMOBILIT]^, SHIVERING, SPRAINED BACK, ETC. 

Immolilite is a term applied by French veterinarians to those 
cases of muscular irregularity manifested by the inability of the 
horse to turn round quickly without falling. He may be able to 
trot in a straight line well enough, but when turned round 
sharply, immediately falls. A modified -form of this disease is 
very often encountered when the animal, although able to turn 
without falling, does so with great difiaculty, throwing the hind 
legs about in an awkward, unsteady manner, and seemingly 
without power to regulate their movements ; the hind quarters 
reeling from side to side, clearly showing that the muscular 
movements are imperfectly controlled by the power of volition. 

This is commonly called broken, sprained, or jinked badi- by 



248 LAMENESS. 

horsemen. It is not due to any fracture, nor always to any 
external injury, but is a progressive disease, arising from some 
alteration of structure in the spinal cord from disease of the 
vertebra, or from granular degenerative disease of the muscles 
themselves. 

" Shivering " is another peculiar nervo-muscular affection of 
the posterior extremities, resembling stringhalt, and manifested 
more particularly during the acts of "backing" or "turning 
round." 

In a case of this kind the animal, when made to back, wiU 
perform that act with some difficulty; the muscles of the 
gluteal and femoral regions are thrown into a state of " clonic 
spasm," contracting and relaxing in a very irregular manner; 
hence the term " shivering," from the resemblance of the mus- 
cular action to trembling or shivering. In many cases the 
tail is spasmodically elevated and depressed in the manner of 
a pump-handle, and the limbs elevated from the ground by a 
peculiar rigid or stiff movement ; the foot often suspended for 
a moment, as if the animal were unable to direct the action of 
the muscles. 

When moved forwards, the necessary actions will be per- 
formed tolerably weU, but the backward movement is done with 
more or less difficulty, and sometimes it cannot be performed 
at all. 

Shivering, immohilite, strained back, and their various modi- 
fications, must be considered as causes of unsoundness, since 
their tendency is to increase in severity as the animal becomes 
older. They often interfere with his condition, and generally 
give him an aged appearance before he has reached his prime ; 
and they prevent him lying down, particularly if he is confined 
in a stall. Some horses, while so affected, lie down well 
enough ; the majority, however, scarcely ever do so, but faU 
down in their sleep occasionally, and being unable to rise 
again without assistance, often injure themselves by struggling. 
Animals of this kind should always be slung at night. 

Hereditary tendency. — I think there can be no doubt as to 
hereditary predisposition being one of the causes of the fore- 
going diseases ; indeed, I have had sufficient proof, in my own 
experience, to convince me that such is the case. Very often 
one form or other will be found in young animals, two or three 



IMMOBILITE, ETC. 249 

years old, that have been subjected to no hardship, arising 
spontaneously, and increasing by slow degxees. I have one 
instance on record where four young horses, the progeny of a 
dam that was affected in the back, died from spinal paralysis 
before they had attained the age of three years. A fifth is now 
living, and shows signs of aggravated nervo-muscular disease. 



MYOSITIS, OR INFLAMMATION OF MUSCULAE STRtTCTUEE. 

The muscles may be inflamed, either from external or internal 
causes, those of the lumbar and gluteal regions being most 
generally so affected. The intrinsic cause of myositis is the 
presence of the rheumatic poison in the blood ; and the extrinsic 
causes are sprains, the application of direct violence, or of 
cold and moisture. It is expressed by pain, swelling, heat, and 
loss of function. Inflammation of the muscles of the dorsal, 
lumbar, and gluteal regions has often been confounded with 
"laminitisj" but a careful practitioner need not make such a 
mistake. 

In laminitis, as well as myositis, there is great stiffness. In 
laminitis there is a tendency, more particularly in the hind feet, 
to elevate the feet from the ground alternately. In myositis 
there is no such tendency, the feet being flrmly planted on the 
ground, and there allowed to remain, if the animal be not forcibly 
moved. In laminitis, when the animal is down, the symptoms 
of fever and pain are considerably alleviated. In inflammation 
of the muscles there is no tendency to lie down; and if the 
animal were forcibly cast, as is sometimes done in laminitis, the 
symptoms will become aggravated. A horse with fever in his 
hind feet wiU generally, immediately on rising, begin to shift 
them, become very uneasy, much distressed, and at last will lie 
down with a sigh of relief; the pulse falling, in the course of a 
few minutes, perhaps thirty to forty beats per minute. 

In some cases of laminitis there is a disinclination to lie 
down ; but when such are forcibly laid on a comfortable bed, 
they generally feel inclined to remain recumbent, and, as a rule, 
it is only necessary to lay them down once or twice before they 
find out the benefit, and take advantage of it without assistance. 

When the muscles of the loins and quarter are inflamed the 
symptoms will simulate those of stringhalt. 



250 LAMENESS. 

I have merely pointed out these essential marks of difference 
at present; a more detailed account of laminitis will be given 
hereafter. 

The treatment of muscular inflammation, when not caused by- 
such a degree of violence as to destroy the vitality of the parts, 
is very simple,— a gentle purgative, rest, fomentations. Should 
atrophy succeed the active stage, a mild blister. 



EHEUMATIC LAMENESS. 

The lameness is characterised by what is termed metastasis, 
or a shifting of the seat of the disease from one part to another. 
The favourite seats of rheumatism, occurring after influenza, are 
the sesamoid burste ; but it may appear in almost any serous or 
synovial structure. It is not rny intention here to enter into 
the pathology of rheumatism, that being reserved for another 
volume; but I may lay down a simple rule for its treatment. 
A strong vesicating blister should be applied to the part and 
around it without loss of time, all other local applications being 
in my opiaion worse than useless. A blister is supposed to act 
by attracting the rheumatic poison into its vesicles, and removing 
it from the system by the bursting of such. It is recom- 
mended by Dr. Eichardson and others that the blister should 
be near, but not upon, the diseased spot ; but I have found this 
inconvenient, and a direct application to answer every purpose. 

A horse suffering the greatest agony from rheumatism is re- 
lieved in the course of one day, provided a numerous crop of 
vesicles be produced. The cantharides blister is the best; a 
purgative is useful after the blister. If the lameness be not 
thus removed, colchicum and nitrate of potash are to be adminis- 
tered ; and if these fail, the iodide of potassium, or carbonate of 
soda or potash, with vegetable tonics. 

In dogs, rheumatism is commonly called Kennel Lameness. 

It attacks young sporting dogs more frequently than any 
other class. The cause is usually to be found either in the 
construction of the kennels or their management ; damp or cold 
situations, bad drainage, a short supply of clean straw, and want 
of exercise, are each and all liable to produce this intractable 
disease. The symptoms are general rigidity, accompanied with 
great pain, as evinced by the anxious expression, hurried breath- 



RHEUMATIC LAMENESS, 251 

ing, disinclination to move, and pain on manipulation; the 
pulse is hard and quick. The tendency of the disease is to 
localise itself in the joints, attacking one or more at first, dis- 
appearing from there, and appearing in others. 

Treatment. — Put the patient in a dry warm place, and ad- 
minister an aperient. Great relief will be obtained by immer- 
sion in warm baths ; care being taken to prevent chill afterwards. 
The affected joints are to be stimulated with soap liniment; 
alkalies, diuretics, and nourishing but easily digested food, are to 
be given ; and when the more acute symptoms have passed off, 
citrate of quinine and iron. 

The terms rheumatism and rheumatic lameness are often mis- 
applied. For example, scrofulous disease of the joints in horned 
cattle is commonly thought to be rheumatic in its character, and 
due to external causes, such as cold, damp, &c. ; whereas, in 
reality, it is an intrinsic disease, and due in the great majority 
of instances, more especially when it occurs amongst high-bred 
stock, to a system of in-and-in breeding persisted in for too long 
a period. Again, a disease — osteo-raalacia — often terminating in 
spontaneous fracture of the bones, which prevails amongst horned 
cattle pastured on poor land, and occurring mostly during dry 
summers, is supposed to be of rheumatic origin, whilst in reality 
the stiffness of the joints and lameness are symptomatic of mal- 
condition of the body generally, and of the osseous system parti- 
cularly, due to the want of proper food in sufficient abundance, 
or to somethrag deleterious in it. In Wales this disease is sup- 
posed to be caused by the animals eating the purging or mountain 
flax {Linum Catharticum), which is found growing amongst the 
pastures in such situations. I cannot endorse the popxilar idea 
that this plant is the cause, for cattle refuse to eat, indeed, turn 
away from it. I look upon it more as an evidence that the land 
is poor, and the pastures, particularly in very dry seasons, defec- 
tive iu nutritious elements. 

The symptoms are depravity of the appetite, rapid emaciation, 
venous murmurs ; stiffness of the limbs, swelling of the joints, 
and difficulty, or even inabUity, in rising from the recumbent 
position. 

The post moiiem appearances are remarkable. The whole 
body is wasted, the muscles ansemic and flabby, the blood is thin 
and watery, and the tissues are oedematous and softened. 



252 LAMENESS. 

Parasites are often present in large numbers in the stomach 
and intestines. The bones are enlarged and softened, crumble 
upon the application of slight pressure, and if fractures have oc- 
curred some time prior to death, it will be found that the repara- 
tive process has been but very imperfectly and feebly established. 

In this disease a peculiar pathological process obtains, similar 
to that which is witnessed in the general emaciation of phthisis 
pulmonalis, described at page 49 of my Principles and Practice 
of Veterinary Medicine, namely, the absorption of a tissue, and 
its redeposition ; but in this disease, instead of fat being absorbed, 
it is found that the calcareous ingi-edients of some bones are 
removed by absorption, and deposited in the form of osseous 
tumours upon various other bones of the skeleton, obliterating 
cavities of reception, and causing deformity of the bones them- 
selves. 

The prevention of this disease is to be accomplished by 
proper diet ; change of pasture if possible, if not, the addition of 
cake or other nutritious feeding material; whilst the pastures 
themselves are to be manured with artificial and other dressings 
— the phosphates of hme, nitrate of soda, or the salts of ammonia, 
as may be determined upon by a competent analyst. 

In the early stages, the disease may be successfully combated 
by antacids, tonics, occasional but mild aperients, and proper 
food ; but if the osseous system is greatly involved, treatment is 
useless. 



CHAPTER XIII. 

PAETICULAR LAMENESSES. 

SHOULDER LAMENESS SHOTJLDEK - SLIP ELBOW LAMENESS — SPRAIN 

OF RADIAL OR SUPERIOR CARPAL LIGAMENT CARPITIS. 

SHOULDER LAMENESS. 

There are three forms of shoulder lameness, which may exist 
independently of each other. One of them is illustrated in 
Photo-lithograph, Plate IL, Mg. 1. These three causes are — 
(1st.) Disease of the shoulder-joint. Photo-lithograph, Plate III., 
Fig. ' 1 ; (2d.) Sprain of the ilexor brachii. Photo-lithograph, 
Plate I., Pig. 5 ; and (3d.) Sprain of the antea and postea 
spinati, teres major and minor, muscles, but more particularly 
of the spinati, as they are mostly concerned in performing the 
function of binding ligaments, connecting the scapula and the 
humerus. 

Mr. Percivall and others were of opinion that injury to the 
serratus magnus was a frequent cause of shoulder lameness. 
Professors Dick and Barlow taught that such could hardly 
be the case, and my experence leads me to endorse their 
opinion. 

The three above mentioned are the usual causes, but there 
are others sometimes met with, namely, rheumatism ; fracture ; 
liver disease ; formation of abscesses in the brachial glands, as a 
sequence to, or sometimes a primary manifestation of strangles ; 
open joint and necrosis of scapula. — (See Photo-lithograph, Plate 
L, Fig. 6.) 

Disease of the Shoulder-Joint may arise from a variety of 
causes, as sprains or rheumatism. Inflammation having been 
set up in the structures of the joint; the capsular ligament 



254 PAKTICULAE LAMENESSES. 

becomes thickened, in other parts diminished, in structure; 
distended by synovia and exudation; the articular cartilage 
is removed by ulceration, or, in rheumatoid disease, converted 
into the porcellaneous deposit; the capsular ligament and 
synovial membrane, with its fringes, becoming at the same time 
loaded with calcareous matter. — (See Photo-lithograph, Plate 
II., Fig. 1.) When the cartUage is ulcerated, there is caries 
of the heads of both scapula and humerus, and afterwards 
anchylosis of the articulation. — fSee Photo- lithograph, Plate III, 
Eg. 1.) 

At one time all obscure lamenesses in the fore extremity 
were attributed to the shoulder, and one heard of nothing but 
shoulder lameness. A reaction, however, took place, after 
Turner re-discovered navicular disease, in favour of the latter, 
which for many years bore the palm ; but now these extreme 
views have been much modified, although there are still some 
who attribute everything to the foot, and others to the shoulder. 
It must be understood, however, that there are shoulder as weU 
as foot lamenesses, and a proper diagnosis must be made of 
each case by the practitioner, who, if enlightened, never weds 
himself to the one theory or the other, but is guided by such 
facts as present themselves to his notice. 

Diagnosis. — The gait of shoulder lameness is indicative of 
the seat of disease. The patient does not carry his limb 
straight forward, but with a rotatory motion, the limb being 
thrown outwards, and the toe made to form the segment of a 
circle ; in other words, he brings the leg forward with a sort of 
sweep, and in some cases the toe of the foot is dragged or 
trailed along the ground. In shoulder and knee lameness more 
particularly, the signs of pain are more discernible during the 
elevation of the foot from the ground ; whereas in foot and other 
diseases below the knee, the converse is the rule. 

Upon manipulation, it wiL. be discovered that pain, heat, and 
swelling are present. In order to discover the swelling, it will 
be necessary to push the levator humeri muscle to one side. It 
is but loosely attached to the shoulder joint, which it covers. 
The next test is to take hold of the limb, and move it backward 
and forward, to perform flexion and extension, when the animal 
will shrink, and evince considerable pain. In some well-marked 
cases the extension of the fore arm by the examiner will cause 



SHOULDEE LAMENESS. 253 

the animal to rise bodily from the ground. It must, however, 
be always understood that uneasiness when these move- 
ments are performed, or when the shoulder is pressed upon, 
is of itself insufficient to determine the seat of lameness, as 
many horses are fidgety, and will not bear such handling. 
But if there be a drag in the gait, along with the other 
signs, it may fairly be concluded that the case is one of 
shoulder lameness. 

Sfrain of the Flexor JBrachii. — This muscle contains a large 
amount of tendinous fibres, and is entirely tendinous as it passes 
over the bicipital groove in front of the superior extremity of 
the humerus, over which it plays like a rope over a piiUey, 
becoming inserted finally into the inner head of the radius. 
Both it and the groove are lined with fibro-cartilage, and 
enclosed within a synovial sac. It extends from the sca- 
pula to the head of the radius, and its function is to flex 
the fore arm upon the shoulder, — an important function, ren- 
dering the structures which perform it liable to injury and 
disease. 

In sprain of the flexor brachii, the muscle, along nearly all 
its course, will be found swollen and inflamed, standing out 
prominently from the surrounding structures. This swelling, 
along with that of the bursa in fro7it of the shoulder, pain upon 
pressure, and the gait peculiar to shoulder lameness, namely, a 
difiiculty in elevating the foot from the ground, are the diagnostic 
symptoms. 

It might be supposed that disease of the bicipital groove 
would, from contiguity of situation, be always accompanied by 
disease of the shoulder-joint itself; but such is not the case, 
as may be seen from an examination of Photo-lithograph, 
Plate I., rig. 5. In many cases, however, the joint becomes 
afiected. 

The result of sprain of the flexor brachii is inflammation of 
the tendon and the structures of the bursa, which, if not arrested, 
win run on to ulceration of the cartilage upon the tuberosities of 
tlie humerus, to caries of the bone, degeneration and rupture 
of the tendinous fibres, and finally to ossification of the whole 
substance of the muscle and tendon. The reason why ossifi- 
cation, and not atrophy, as in inflammation of other muscles, 
must be looked for, is the fact that the flexor bracldi is mostly 



256 PARTICULAH LAMENESSES. 

composed of tendinous fibres, and long-continued inflammation 
of tendons usually ends in their ossification. 

The causes, like those of the next variety, are generally due 
to the horse being worked at the plough, and on the off side, 
by which his limbs and shoulders are thrown into an irregu- 
larity of position; that is to say, one foot is placed in the 
furrow, and the other on the land. One shoulder is thus in a 
lower position than its fellow, an extra amount of weight being 
at the same time thrown upon it, so that in the course of time 
its structures become diseased. 

Sprain of the flexor brachii from the above cause is confined 
generally to the off side, and this can be easily understood from 
the extra work it has to perform in elevating the foot which is 
in the furrow to the level of that which is on the land. Plough- 
ing is not the only cause of this form of lameness ; but a horse 
that has been sprained in this tendon is seldom fit for the plough 
again. He may work on the road well enough ; but as soon as 
he is put in the plough the lameness returns. In some instances 
rheumatism becomes localised in the flexor brachii, and is a cause 
of intermitting lameness. 

In the treatment of both shoulder-joint and flexor brachii 
lameness, great advantage is derived from the application of the 
high-heeled shoe. This enables the horse, while standing, to 
have the diseased structures in a state of relaxation and repose. 

" SHOULDER-SLIP." 

By this is meant that peculiar outward slipping movement 
of the shoulder-joint at each step the animal takes when the 
foot of the lame limb is upon the ground, the opposite one 
elevated from it, and when the weight of the horse is thus thrown 
upon the lame side. 

It would appear almost as if the shoulder were out of joint, 
hence the term " shoulder-slip ;" but such is not the case, as the 
following observations wiU explain. 

The scapula and humerus are not bound together by lateral 
or binding ligaments, as is the case with other joints, the 
movements between them being so varied and extensive, that 
inelastic ligaments would not allow them to be performed. 
They are consequently bound together by muscles, whieh 



SHOULDEE-SLiP. :2'57 

perform the function of ligaments, and admit of a variety 
and extent of motion ty their power of contraction and re- 
laxation. 

These muscles are the antea and postea spinatus and teres ex- 
ternus. The spinati, which are mostly concerned in this, are 
lodged in the fossae of the scapula, covering its whole external 
surface, and attached inferiorly to the tuberosities and ridge of 
the humerus, and to the capsular ligament of the shoulder- 
joint. It will be seen from their position that their action is 
mainly to prevent the outward bulging of the head of the 
humerus, to keep the parts firmly and closely in their respec- 
tive situations, and to assist in the elevation and adduction of 
the humerus. 

It win be remembered that there is great disparity between 
the articular head of the humerus and the glenoid cavity of 
the shoulder, the latter being much smaller than the former. 
This disparity of size allows a liberty of motion without dis- 
location that otherwise would be impossible, assisted and 
kept within moderate bounds by the action of the foregoing 
muscles. 

This form of lameness is generally seen in horses that are 
worked in the plough, and in the horse that works in the 
furrow. Mr. Barlow said, " always in the limb that is placed 
in the furrow ;" but I cannot endorse this, having often seen it 
in both shoulders. 

The explanation is, I think, simple, the functions of the 
muscles being — 1st. To keep the parts firmly together ; 2d. To 
prevent the outward bulging of the head of the humerus ; 3d. 
To draw the head of humerus outwards when the glenoid cavity 
overlaps its outer border ; and ith. To assist in lifting the limb. 
Now, when the limb is, as it were, made longer than its fellow, 
by the foot being placed upon lower ground in the furrow, it 
necessarily follows that the work to be performed by these 
muscles is increased to a considerable extent, as the limb seems 
to hang from the shoulder ; and that, in consequence, the demand 
upon them is beyond their power of endurance. Inflammation 
is excited in the muscular structure, and often in the tendons ; 
the exudation presses upon the true sarcous fibriUse, which, along 
with degradation of their constituent elements consequent upon 
the injury, leads on to atrophy. 

s 



258 PARTICULAR LAMENESSES. 

A muscle, when inflamed, or when atrophied, loses its power 
of contractility and its tone ; and in this form of lameness the 
shoulder bulges outwards when the weight of the animal is 
thrown upon the lame side, because the muscles which bind the 
shoulder, and limit the great extent of motion between the 
scapula and humerus, are no longer able to perform their 
functions. So much then for the shoulder of the off side limb ; 
and we must now endeavour to explain how " shoulder-slip " 
can occur in the near side, or that which is placed upon the 
land, and higher than its fellow during ploughing. 

The second function of these muscles is to prevent the out- 
ward bulging of the shoulder-joint, more particularly the head of 
the humerus, — a condition of the joint which occurs always 
when a limb is placed upon higher ground than its fellow, as 
any one might see by watching a horse working in the plough. 
There is a bulging outward, a contortion in fact, at every step 
the animal takes ; the parts are thrown out of their equilibrium, 
first into a state of undue relaxation, by the upward pressure of 
the humerus, then of undue extension, by the outward bulging. 
Again, both fore feet may be occasionally in the furrow, and 
the hind ones also. Tliis, with slipping in and out, and the 
inequality of the land, brings on, particularly in the young horse, 
a state of irritation which finally terminates in inflammation 
and atrophy. 

It is seldom that any but young horses suffer from this lame- 
ness, as older horses become used to their work, and are able 
to avoid injuring themselves. Great care is therefore required 
in bringing the young horse gradually to his work, — in fact, " to 
break him in " with due caution, by placing him at the side of 
a steady, quiet old horse ; one that will not outpace him, nor 
fatigue him in his work. When an animal becomes fatigued 
he loses command over his action, becomes unsteady in his gait, 
and is thus rendered liable to sprain himself. 

Symptoms. — In some cases there will be swelling and heat 
over the course of the muscles, upon the outer surface of the 
scapula, and in the joint itself; but in the majority of cases 
actual lameness does not occur until the muscles have become 
considerably atrophied, and instead of swelling, there will be 
a wasting of the shoulder. There will be a hollow space upon 
either side of the scapular spine, extending its whole length. 



SHOULDER-SLIP. 359 

The spine is thus rendered prominent, standing out as a sharp 
ridge from its surrounding structures. By standing in front of 
the horse, if one shoulder only is affected, and by comparing the 
two shoulders, the difference can at once he detected. If both 
are diseased, this comparison wiU not be of any service, but it is 
seldom that they are both alike ; in one, the antea spinatus, in 
the other, the postea spinatus, is the more atrophied. This 
atrophy is different from that wasting of the shoulders seen in 
chronic foot lameness. In the one case, the muscles of the 
external surface of the scapula only are wasted ; -whilst in the 
other, all the muscles of the shoulder and arm are in that 
condition. 

Shoulder-slip is curable, provided the tendons of the muscles, 
the rim of the glenoid cavity of the scapula, or the external 
trochanter of the humerus, be not organically altered in struc- 
ture. The alterations found in these are abrasion of the tendons, 
ulceration of the cartilage covering the bones over which they 
glide, and caries of the bones themselves. 

Treatment. — During the inflammatory stage, purgatives, fomen- 
tations, removal of shoes, and rest. After the muscles are wasted, 
repeated applications of moderate stimulating remedies, such as 
mild blisters, and a long period of rest in a strawyard, or at grass. 
When recovered, the patient should be put to other work than 
ploughing. 

Some dealers have no objection to horses with wasted shoul 
ders if they go sound, as it is well known that they will perform 
their work well enough if not put to the plough. JSTotwith- 
standing this, I hold that it is an unsoundness in law, and that 
it always depreciates the animal's value. I have seen many 
young carriage-horses suffer from this form of unsoundness, 
resulting from working in the plough; but I cannot recuUect 
one instance where they were rendered permanently unfit for 
carriage work. 

This fact is important, if it become the universal law that \m- 
soundness means unfitness for work. I mention this because I 
have heard lawyers argue and judges rule that such is the " law 
of warranty." 

It might be supposed that the atrophy of the muscles of the 
shoulder, which is so well marked in this form of lameness, only 
became apparent after a considerable interval had elapsed subse- 



^QOh PAETICULAE LAMENESSES. 

q^uent to the sprain of the muscles. ' Such, howeVer, is not the 
case; and it may be laid down as a fact that well-developed 
atrophy occurs in the course of three weeks after a sound horse 
has been put to work ; and in many instances it seems the altera- 
tion has been due to an irritation, not amounting to inflamma- 
tion, leading directly to mal-ntitrition, without the occurrence of 
swelling or exudation. 

When shoulder lameness arises from disease of the liver, it 
occurs in the off side only, and is associated with loss of appetite 
and yellowness of the mucous membranes. 

Abscesses in the brachial or pre-scapular ganglia of the lym- 
phatic glands may be the cause of lameness in the shoulder.' 
These glands are situated between the scapula and thoracic walls, 
and are liable to become inflamed, primarily or secondarily, in 
strangles, phlebitis and pyaemia caused by wounds upon the 
limb, or even after neurotomy, causing great pain and lameness. 

Inflammation of these glands may be detected by swelling,, 
pain, and heat in front and below the point of the shoulder, in 
the space existing between the sternum, scapula, and humerus. 
The limb will be pushed outwards by the swelling, there will be 
much fever, and the inflammation and suppuration are relieved 
only by the opening of the abscess or abscesses, spontaneously 
or surgically. , . . 

The pus is very deep-seated, and it is necessary to open the 
abscess in nearly every case of this kind, and to do it before 
there are any signs of "pointing." In such cases, I always 
explore with a " pin-director," and invariably find out where the 
pus is situated. I then make a deep opening with a " Syme's 
knife." 

ELBOW LAMENESS 

Occurs from disease of the joint, sprain of the lateral ligaments, 
and from laceration of the triceps extensor brachii muscle. 

The internal lateral ligament may be sprained, or even 
ruptured, by the animal's . fore leg slipping outwards. The 
triceps muscle is often injured in the manner already described 
at page 132, and by the animal's fore feet slipping forwards. 
These accidents commonly happen in frosty weather. Cattle 
are also liable to these injuries, particularly to sprain of the 
internal ligament. 

When the ligaments are sprained, or the triceps injxired, the 



ELBOW IjAMENESS. ! 2G1 

diagnosis of the seat of lameness is easy, for there will ' b? 
swelling, pain, and heat, in addition to difficnlty in moving the 
articulation. When the internal ligament is injured, the horse 
stands with his foot a^d limb thrown outwards. This he does 
to prevent, as much as possible, the injured parts being pressed 
upon by the pectoral muscles ; and when the triceps is the seat 
of the injury, the fore arm is flexed upon the humerus : the 
action of the flexor brachii being now unopposed, the knee 
is elevated, the leg flexed from the knee downwards, the toe 
of the foot touching the ground, and the limb s.emi-pendulous< 
When tlije horse is made to move, he drops considerably^ and 
seems in danger of falling at every step he takes, the limb 
itself almost bending double when any weight is thrown upon 
it. , This excessive dropping, during progression, is characteristic 
of elbow-joint lameness, even when there are no external signs, 
such as heat, swelling, or pain, visible. 

Percivall describes a case of elbow-joint lameness in his book 
on lameness, published in 1849, where the symptoms were 
siinUar to those of laminitis. I have never witnessed anything 
similar to what is described by Percivall, namely, an animal 
putting the heel first , tO; the ground in elbow-joint lameness. 
Usually the Umb is semi-flexed, in order to relax the articula- 
tion as much as possible ; the toe, during motion, first coming 
to the ground. 

The diagnostic signs of elbow-joint lameness are, first, the 
senji-flexed position of the Hmb whilst the horse is standing 
stiU ; and the excessive dropping of the head and anterior parts 
of the body during action.. 

Professor Dick used to say that the capsular ligament, 
distended , with synovia, could be felt through the skin and 
subcutanepus structures. I have, however, not been 'able to 
confirm this. Photo -lithograph, Plate III., Pig. 2, is a good 
illustration of elbow-joint lameness. , , 

A small wound upon or near to the, olecranon gives rise to 
very peculiar symptoms. The wound itself may be so small 
as to escape detection without a very careful examination. 
It may be situated upon the very point of the olecranon, or 
upon its side, or even in the spa,ce between the thoracic wall 
and elbow. The wound is inflicted commonly whilst hunting ; 
the rider, not knowing that it has been received, rides his horse. 



262 PAETICULAE LAMENESSES. 

and as a result of motion, air is, as it were, pumped into the sub- 
cutaneous areolar tissue, inflating it, first in tlie neighbourhood 
of the wound, and then, if the movements be continued, over 
the greater part of the animal's body. I have seen the head 
swollen to a tremendous extent, the eyes closed by the swollen 
lids, the neck, shoulders, dorsal and posterior regions so blown 
up, that the classification of the patient in the animal kingdom 
became a matter of some difficulty. Such a condition need 
occasion but little alarm ; aU that wiU be req^uisite is to find 
out the wound, clean it well with warm water, plug it up with 
tow dipped in collodion, and keep the animal stiU. In a short 
time the air wiU be absorbed, and the swelling dissipated. If 
the nostrils are so greatly swollen as to interfere with the 
respiratory functions, endangering the animal's life, it will be 
necessary to puncture the skin surrounding them, and press out 
the contained air ; but if this is not the case, there is no neces- 
sity for making any punctures. 



SPRAIN OF THE KADIAL OK SUPERIOR CARPAL LIGAMENT. 

This hgament, sometimes described as a broad band of fibrous 
tissue, springs from the posterior surface of the radius, and 
becomes inserted into the flexor perforatus above the knee, 
and is also continuous with the perforans muscle and ante- 
brachial fascia. It will be noticed, upon dissecting the fore 
extremity, that the flexor muscles of the radial region are 
intermixed with a large quantity of white fibrous tissue — 
in fact, they are semi-tendinous in their structure ; and that, 
both above and below the knee, any undue extension of them 
is checked by ligamentous bands, which arise from the radius 
and metacarpus magnus, and become continuous with their 
tendons of insertion. 

The peculiarity of construction here noticed enables the horse 
to sleep while standing. The feet are made fixed points by being 
planted firmly on the ground, and these muscles, acting as 
extensors of the shoulder, prevent the animal from falling by 
keeping the limbs in a state of rigidity. Had they been com- 
posed wholly of muscular tissue, this long-continued action 
would have been an impossibility ; but containing as they do a 
iarge amount of tendinous structure which is beyond the influ- 



SPEAIN OF EADIAL LIGAMENT. 263 

ence of the nervous system, and hence beyond the possibility 
of fatigue, the mere implanting of the feet upon the ground, 
by causing the muscles to be stretched, produces a state of 
rigidity and firmness in the limbs that enables the animal to 
stand and sleep for hours together without danger of falling. 
The muscles are strengthened and assisted by the ligament- 
ous bands: from this circumstance, and from their acting as 
checks to over-extension, they are liable to sprain or even 
rupture. 

Sprain of the radial ligament is manifested by lameness, a 
difficulty in the act of flexing the knee, with swelling, beat, 
and tenderness immediately above the knee, posterior to the 
radius. The swelling arises from exudation of lymph into the 
substance of and around the ligament, and from distension of 
the synovial bursa, through which the tendons pass, behind the 
knee. In some cases, both perforatus and perforans also are 
involved in the injury : in such the lameness, pain, and 
swelling are excessive, and flexion exceedingly difficult, arising 
from the swollen tendons being too thick to play through 
their thecse, — just as a rope too thick for a pulley retards 
motion. 

The distension of this bursa appears as a tense but fluctua- 
ting swelling at the back, and slightly above the knee, and is 
sometimes called thorough-pin of the knee. 

The tendons of the various muscles concerned in the flexion 
and extension of the knee, pastern, and foot, passing through 
thecae upon the surfaces of the carpus, are liable to injury, 
with distension of their various synovial sheaths from hyper- 
secretion of synovia. We have thus the theca of the flexor 
metacarpi externus made visible on the outer surface of the os 
trapezium ; the sheath of the flexor metacarpi internus on the 
inner side of the knee ; that of the extensor metacarpi magnus 
in front of the knee as a swelling on either side of the tendon ; 
and those of the other extensors upon the outer surface of the 
carpal articulations. 

These enlargements, when arising from injury, and conse- 
quent thickening of the tendons themselves, or inflammation of 
the synovial membrane, cause lameness ; whilst at other times 
they are mere bursal distensions giving rise to no inconveni- 
ence. 



264 PARTICULAK LAMENESSES. 

In the neighbourhood of copper and iron smelting works, 
bursal enlargements are diie to the impregnation of the animal 
system with mineral poisonous materials. The poison, finding 
ingress by means of the atmosphere into the lungs and circula- 
tion, becomes deposited in and around the articulations, more 
especially of the knees, and finally produces anchylosis. 

All cases where the tendons are thickened must be looked 
upon as unsound, since they are tied down by the enveloping 
thecse and annular ligaments, through which they play; and 
any thickening of their substance must destroy that facility of 
motion which is so essential to soundness of action. 

The bursa of the extensor metacarpi magnus sometimes be- 
comes greatly distended — constituting what is termed " capped 
knee,' — from blows and bruises, or the entrance of thorns whilst 
hunting and jumping thorn fences. These thorns may remain in 
for years without causing any apparent inconvenience to the 
animal beyond some sweUing. 

When capped knee is first observed it is generally accom- 
panied by some stiffness and pain, showing that more or less 
inflammation is present. These symptoms should be combated 
by purgatives, fomentations, and quietude. After a time all 
signs of inflammation pass away, leaving a fluctuating swelling. 
This swelling may either be punctured at once, or its reduction 
attempted by the application of blisters. Of course, if a thorn 
can be detected it must be at once removed. Blisters, when 
sufficiently strong, often cause the reduction of these swellings 
by producing an exudation of lymph into the distended sac, 
converting the soft, fluctuating swelling into a hardish, indurated 
mass, which is gradually removed by absorption. But if blisters 
— and I prefer the cantharidine one to any other, with mode- 
rately firm pressure after the soreness of the blister has passed 
away — ^have no effect in reducing the swelling, the practitioner 
need not hesitate to puncture and allow the contained fluid to 
escape. The puncture should be made at the lowest margin of 
the swelling, and upon its inner side, by a transverse incision, 
in order to blemish as little as possible. After the puncture is 
made and the fluid pressed out, the walls of the sac must be 
kept in apposition by means of an antiseptic bandage, rolled 
round the knee from above downwards, until they become united 
by the adhesive inflammation. The bandage should not be dis- 



SPEAIN OF EADIAL LIGAMENT. 265 

twrbed for five or six days if no inconvenience is caused to the 
patient ; but if any signs of pain are manifested, it should be 
removed and readjusted. The puncture in the skin must be 
kept open (and the best plan to do this is to insert a small piece 
of lint or tow into its orifice, allowing it to remain in for a few 
hours), in order to allow the escape of any fluid which might 
coUect in the sac. The bandage is placed so as not to cover 
the wound. There is no danger to be apprehended from open- 
ing this bursa. I have done it repeatedly, and always with 
success ; and sufficient inflammation is usually excited without 
injecting iodine or any other irritant. 

Horned cattle, especially milking cows, kept in-doors, are 
liable to have enormously enlarged knees from distension of 
these bursse, caused by bruising while lying upon hard floors. 
They may be opened with safety ; and the best plan of doing so 
is to insert a seton right through the substance of the swelling, 
and allow it to remain in for three or four weeks ; the knee to 
to be protected from further injury by a good thick bed, or loj a, 
thick flannel bandage wrapped round it. 



CAEPITIS, OK INFLAMMATION OF THE KNEE. 

This cause of lameness was investigated and laid before the 
profession by Mr. Arthur Cherry (.Veterinarian, 1845). He 
gives a very elaborate account of it, which may be read with 
advantage ; but in his over-zeal for what seems a pet theory, he 
has confounded diseases of other parts of the limb with those of 
the knee. For example, he says that " heat in the foot is some- 
times felt in carpitis," and that what the old farriers called 
chest-founder arose from this inflammation of the knee. These 
statements must not be received without great caution, as they 
are apt to mislead the young practitioner. Mr. Cherry says— 
" Under the term Carpitis I propose to describe a disease of the 
knee-joint which, in its commonly existing form, has never, as 
far as I am aware, been speciiicaUy described. 

" The knee-joint itself has been considered to be exempt from 
disease, unless from the infliction of direct injury; indeed, so far 
did the late Professor Coleman carry his opinion on this subject, 
that he used to assert, in the most positive manner, that the 
knee was never the seat of lameness, : 



2C6 PAETICULAE LAMENESSES. 

Professor Dick, as far as I can remember, did not mentiDn the 
existence of this form of lameness ; and on referring to my notes 
of his lectures, I can find nothing in them to lead me to think 
that he did so, although the Museum contains many specimens 
of the disease. 

"The gait in chronic carpitis," says Mr. Cherry, "affecting 
both knee-joints, gives to a rider the sensation of the chest 
being displaced from its right position — a sinking or ' foundering,' 
and which feels as if it would increase at every step of the horse. 
"When attention is drawn to this peculiar gait, it is easy to be 
distinguished from the short cat-like step in navicular arthritis, 
which gives to a rider a sensation of the chest being raised up, 
or an attempt at doing so ; further, the feet in navicular arthritis 
are brought to the ground with the toe first, and in consequence 
the step is short and stilty, from the weight being as much as 
possible thrown on the column of bones, to relieve the affected 
tendon, or surface over which it plays ; and from the same cause 
there is great inclination to canter, a pace which, when slow, 
brings into play but slightly the flexor tendons or navicular 
joint. In carpitis, on the contrary, these symptoms are reversed, 
from the cause of lameness being seated on, or amongst, the 
carpal bones. The effort is not now to throw the weight on the 
bony column, but on the tendons and ligaments, and by this 
means to avoid concussion ; hence the limb is carried forward as 
nearly straight as possible ; and still further to effect this object, 
it is thrown with a circumductive motion outwards, and brought 
to the ground with the heels first, as is shown by the wearing 
away of the points of the heels of the shoe. This mode of pro- 
gression produces a long step, and at the same time the fore 
quarters are dropped or lowered, which has been, I doubt 
not, the origin of the term 'chest-founder.' There is also a 
disinclination to canter; and if this pace is attempted, it gives 
increased pain, and a rocking motion exceedingly unpleasant 
to the rider. 

" The diagnostic characters of the disease affecting one leg only 
are the same as exist in both, but from the contrast which is 
afforded by the sound limb, these are much more recognisable 
than when both are affected ; to these, however, one other char- 
acteristic must be added — the step of the lame leg being rather 
longer than that of the sound limb." 



CAEPITIS. 267 

The characters are very much akin to those of shoulder lame- 
ness, from which, however, it may be readily distinguished — 
first, by the circumductive manner in which the leg is thrown 
forwards, and the straight knee; secondly, by the absence of the 
dragging of the whole limb ; thirdly, by the stepping on the 
heels, and the greater firmness on standing ; biit one of the best 
guides perhaps in diagnosis is the expression of pain when the 
affected joint is forcibly flexed or extended, and noting which 
joint is attempted to be least brought into use during action. 

Mr. Cherry says — " I am disposed to a belief that there is in 
some horses a hereditary idiosyncrasy to this disease ; be this 
as it may, half-bred are much more prone to it than thorough- 
bred horses." 

The inflammation and its consequences may be confined to 
one of the articulations of the carpus, more particularly to that 
between the trapezoid and inner small metacarpal ; or the dis- 
ease may involve several, or all of the carpal articulations. 

The morbid condition of the joint may consist of simple 
inflammation, terminating, by proper treatment, in restoration, 
or inflammation associated with ulceration of the articular car- 
tilage, caries of the bones, and a deposition of osseous matter 
external to and around the diseased portion, constituting anchy- 
losis. — (See Photo-lithograph, Plate III., Fig. 3). 

The inflammation being deep-seated in the bones, or synovial 
membranes, is not accompanied by much external heat; and 
the articulations of the knee, with their synovial membranes 
and capsular ligaments, being small and incapable of contain- 
ing much synovia, account for the absence of external swelling 
until there is a deposition of osseous matter. 

In many young horses, especially when they are first put to 
work, we meet with an occult lameness which is most puzzling. 
There is no heat, swelling, nor pain upon pressure in any part 
of the Hmb or foot. The animal is moderately sound when it 
first comes out of the stable in the morning, but shows signs of 
increased lameness after being at work for a short time. In such 
cases, the practitioner cannot be far wrong in pronouncing the 
lameness to be in the bones of, or adjacent to, the knee-joint. 

The osseous deposits arising from carpitis, when not caused 
by the fumes of metals, are generally situated on the inner side 
of the joint. This is due to the bones being here more under 



2,68; PARTICULAE LAMENESSES. 

the centre of gravity, receiviiig a larger share of the weight, and 
bearing more concussion than those on the outer side; therefore 
the head of the inner metacarpal, the trapezoid, and os magnum 
in the lower, and scaphoid and lunar in the upper row, are most 
commonly diseased; but it is very rare indeed to iind the dis- 
ease extending to the bones of the upper row. 

Treatment. — Eemoval of the shoes; loose box in preference 
to the field or stall; with other remedies appropriate to lame- 
ness, to be described hereafter. 



CHAPTER XIV. 

PARTICULAR LAMENESSES — continued. 

SPEEDY-CUT BROKEN KNEES SPRAIN OF FLEXOR TENDONS SPRAINS 

OF SUSPENSORY LIGAMENT ^^SPRAIN OF FETLOCK-JOINT SESA- 

MOIDITIS RING-BONES. 

" Speedt-Cut " is the name of an injury to the region of the 
carpus, •which often causes lameness. This injury is inflicted 
by the horse striking his leg with the opposite foot. Sometimes 
the bruise is above the knee, upon the skin covering the promi- 
nent process upon the internal surface of the radius, which gives 
attachment to the lateral ligament of the joint. It is only high- 
stepping horses that are liable to inflict this injury in the trot, 
but in the gallop almost any horse may do it. 

When a horse strikes himself, as in speedy-cut, he is liable to 
fall from the violence of the pain, thus endangering the life of 
the rider, and breaking his own knees. 

In the examination of horses as to soundness, care must be 
taken to detect any marks of former bruises upon the inner 
side of the knee arising from this cause. The marks may be 
on the lower extremity of the radius, or upon any prominent 
part of the inner surface of the knee or head of the metacarpal 
bone. Wherever situated, I am of opinion that they should be 
considered as causes of unsoundness, since they indicate a fault, 
which at any time may interfere with the usefulness of the^ 
animal. 

The sjonptoms of speedy-cut are — inflammation and swelling 
of the skin, collection of fluid in the subcutaneous areolar tissue, 
constituting a serous abscess, or the formation of pus in the 
part, with lameness, accompanied occasionally by a good deal of 
fever. 



270 PAETICULAE LAMENESSES. 

Preyention is better than cure, and many horses will do well 
enough if properly shod with either the three-quarter or Charlier 
shoes. The foot must be kept narrow on the inner side, and 
the shoes removed about every three weeks, otherwise, by growth 
of the foot, the animal is apt to strike. I have known many 
cases of this kind where it was essential to remove and readjust 
the shoes at the end of three weeks, otherwise, mischief was sure 
to follow. If due attention to shoeing does not prevent it, a 
boot must be made, extending as high as the knee, with a rim 
on its upper extremity to keep off, as it were, the interference of 
the other foot. I do not think that narrow-chested are more 
liable to " speedy-cut " than wide-chested animals ; round high 
action being generally the cause. 

The treatment of the active symptoms arising from the injury 
consists in fomentations to the part, purgatives, the opening of 
the abscesses, whether serous or purulent, and the removal of 
any thickening which may remain, after the active symptoms 
have passed away, by the application of iodine or biniodide of 
mercury. 

BROKEN KNEES. 

A wound upon the anterior part of the knee, although of itself 
a mere scratch, is of such importance that it lowers the value of 
the animal to a very great extent. Many are the excuses for 
a broken knee. It is very true that many knees are broken 
through carelessness on the part of the rider or driver ; and in 
judging such the veterinarian must draw a distinction between 
a good and a bad goer, between a well-made horse and the re- 
verse. Marks of speedy-cut and cutting or brushing must also 
be looked for, as the infliction of these is apt to cause the 
animal to fall. 

If a horse, well made, with very fine action, has broken knees, 
the cause may be purely accidental — bad shoeing, carelessness, 
or to the animal being subject to fits of vertigo. 

Broken knees are of five kinds : — 1 st. Wlien the skin is 
bruised, but not cut ; 2d. When the skin is cut ; M. When the 
skin is divided, more or less lacerated, the tendon of the extensor 
magnus exposed, and its bursa opened ; Wh. Wlien the wound 
penetrates through the tendon, exposing the carpal articulations ; 
5th. The last form, with fracture of one or more bones. 



BROKEN KNEES. 271 



1st. Wlien the skin is simply bruised, the hair being, as it 
were, shaved oS, with a little oozing of blood. This need 
cause no uneasiness as to after-blemish, if properly treated ; but 
if treated in the common way— by hot fomentations, flannel 
bandages, and stimulating ointments or liniments — a blemish is 
the sure result. 

The proper method of treatment is as follows : — 1st. Tie up 
the animal's head, so that it cannot lie down. This I hold to 
be important, for the skin may be so injured that but little 
additional pressure is required to cause it to slough, and slough- 
ing, however trifling, will leave a blemish. In addition to 
tying the head, all that is required is to sponge the knee 
lightly with some cooling application, such as the white lotion, 
repeatedly, for two or three days, or untQ the inflammation has 
subsided. If much swelling should arise, a purgative should 
be given. 

2d. When the skin is cut. The edges should be brought 
together as well as possible, and so kept by plaster, or styptic 
coUoid, or shellac paste dipped in lint or tow. A wound on 
the knee must never be pinned or stitched, for flexion of the 
part wiU most assuredly tear out the pin or suture, with a 
piece of skin as well, and thus increase the blemish. In addi- 
tion to the colloid or plaster, a light calico bandage may be 
applied, the horse's head tied up, and the dressing not inter- 
fered with for four or five days, if the case progresses favour- 
ably. But if the leg should swell, or show signs of pain and 
inflammation, the bandages must be removed, and the wounds 
examined ; if found to be suppurating, they are to be lightly 
washed, and afterwards dressed with mild astringents, or very 
dilute carbolic acid — one to 200 parts of water is strong enough 
— or the white lotion, with a small quantity of the carbolic acid, 
will do very well. 

It must be understood that before the edges of the wound 
are brought together, all foreign bodies, such as dirt, hay -seeds, 
&c., are to be removed. Very often a small piece of dead tissue 
wUl be seen, presenting a deadened white appearance in the 
wound. This should be removed by the curved scissors, other- 
wise it will act as a foreign body. 

3d. When the skin is divided, more or less lacerated, ex- 
posing the magnus tendon, it does not necessarily follow that, 



272 PARTICULAE LAMKNESSES. 

although there is a discharge of synovia from the wound, there 
is true open, joint, for the bursa of the extensor metacarpi 
magnus is separated from those of the articulations. 

Cases of this kind look very formidable, the resulting in- 
flammation being sometimes great, the swelling very consider- 
able, extending as high as the elbow-joint, and as low as the 
foot ; the whole limb being infiltrated with effusion and exuda- 
tion. The carpal-joint becomes greatly enlarged by a fibrinous 
deposit, which surrounds it, and the synovial discharge very 
profuse. Generally, with proper treatment, such cases recover^ 
if the tendon be not crushed. 

Ath. If the tendon has been crushed, although neither lace- 
rated nor divided in any way, it may slough in the course of 
foux or five days, its vitality having been destroyed. This 
sloughing of the tendon is attended with severe' symptoms, and 
is a source of great danger to the animal's life. The sympathetic 
fever becomes very high ; the respirations and pulse quickened ; 
the bowels constipated ; the urinary and other secretions, arrested; 
both the wound and tendon assume a dusky livid or leaden 
hue ; the discharge becomes foetid, sanious, mixed with blood, 
and the lameness excessive. When the slough is removed, the 
carpal articulations are exposed to view; the bones are in- 
flamed, and of a red hue. The power of extension is now lost 
by the separation of the tendon from its attachment, and the 
limb is persistently flexed. If an attempt be made to extend 
it forcibly, great pain is inflicted. 

The treatment of such cases, whether the division of the ten- 
don be immediate or not, is a matter of anxiety to the veterinary 
surgeon, and, except when the patient is a valuable stud animal, 
it is better to destroy it, for even if a cure is effected, the 
articulation will be anchylosed ; and a horse with an anchylosed 
knee is of little use. But if an attempt is to be made to effect 
a cure, the limb must be fixed in the straight position by means 
of the tin splint recommended for fractures, placed behind the 
knee, and fastened by proper straps and bandages, leaving the 
wound uncovered. 

In the treatment of open bursa, or even when the skin only is 
divided, it is always advisable to apply the splint for the purpose 
of preventing motion, and to prevent a horse from accidentally 
striking the wounded knee against the manger, to turn him 



BROKEN KNEES. 273 

round in the stable, and supply him with food by means of a 
bag suspended from the stall-posts ; the slings in the graver 
lesions playing a most essential part. 

In some rare instances the wound in the skin and tendon is 
situated at the inferior part of the knee, over the articulations of 
the lower row of carpal bones and the metacarpals. A wound 
in this part, although penetrating deeply and opening into the 
joint, is not nearly so dangerous as one over the articulation 
between the two rows : for there is but little motion, the suc- 
ceeding inflammation is not nearly so great, nor the supervening 
anchylosis so important. 

5th. When the accident has been sufficiently severe to fracture 
one or more bones of the knee, the animal shoidd be destroyed. 

The causes of lameness now to be described, extending to 
the foot, are mostly common to both anterior and posterior 
extremities. When they are not common to both, special 
reference will be made to them. They may be enumerated as 
follows : — 

1. Sprain of the flexor tendons. 

2. „ of suspensory ligament. 

3. Inflammation of the sesamoid bursa. 

4. „ of the fetlock-joint. 

5. Eupture of lateral ligaments of fetlock-joint. 

6. Knuckling over. 

7. Sprain of inferior suspensory ligaments. 

8. Wind-gaUs. 

9. Eing-bones. 

10. Sprained pasterns. 



SPEAIN OF THE FLEXOR TENDONS. 

The so-called sprain of the back sinews is not primarily in 
reality a lesion of the flexor tendons proper, nor of their thecte, 
but consists of a diseased condition, arising from over-extension 
of the metacarpal or metatarsal check ligaments, situated below 
the knee and hock, performing the same functions as the radial 
ligament which has been already described. 

These ligaments arise from below the upper extremities of the 



:S\ 



274 PARTICULAR LAMENESSES. 

metacarpal and metatarsal bones, and run down the legs, lodged 
in the fossae upon their posterior aspect, bounded on either side 
by the small canon bones. They are external and posterior to 
the suspensory ligament, become attached to the great perforans 
tendons half way down the leg, and are there placed to prevent 
over-extension of the tendons. 

Cart-horses are much more liable to this lameness than any 
other breed, in consequence of the great labour they perform in 
drawing heavy loads. This can easily be understood by watch- 
ing a horse start a heav;^'- weight — how he digs his toes into the 
ground, making his feet fixed points, upon which the muscles, 
the flexors particularly, are made to act. The muscles acting 
upon two fixed points, namely, the elbow and foot, render their 
tendons tense and stretched. Wben the impetus is given by 
which the load is started, great strain is thrown upon them and 
their check ligaments, by which they are extended ; and this 
extension, acting upon inelastic structures, causes some of the 
fibres to give way — to become ruptured. Eepeated stretching 
produces a degenerated condition of the fibres, by which they are 
rendered easily lacerable. 

I do not hold that it is always necessary to have actual 
rupture of the fibres to constitute a sprain of a tendon or 
ligament. Inflammation can occur in them, non-vascular as 
they are, without this lesion ; and extension, although not pro- 
ducing rupture, is sufficient to produce the inflammatory con- 
dition, more especially at the points of insertion into the 
bones. 

An additional cause is found in the kind of shoe that cart- 
horses wear in some parts of the country, shoes with heavy toe- 
pieces welded across them. These very materially increase the 
resistance to the action of the flexors, by adding to the obstacle 
to be overcome, that obstacle being the foot placed on the 
ground with the weight of the animal upon it. The foot is ele- 
vated upwards and backwards, the last part to leave the ground 
being the toe ; and as it does so it is made to describe the 
segment of a circle : we therefore find that the toe of the shoe 
is rounded off as it wears. It will easily be understood how 
any additional resistance to this last act in its elevation becomes 
a source of disease in the structures which perform it. No one 
can deny that toe-pieces enable the horse to have a stronger 



SPRAIN OF FLEXOR TENDONS. 275 

hold on the groimd, and thus prove an advantage wlien very 
heavy loads are to be moved, more especially in hilly districts, 
but this very advantage of grip hecomes a cause of lameness, 
from the fact that it has to be overcome by the active organs of 
locomotion. 

When a ligament or tendon is inflamed, an exudation takes 
place hoth within and external to its substance. That within 
the structure, or the inter-fibrous exudate, separates the fibres 
from each other, causes them to diverge from the straight line, 
and thus the ligament or tendon becomes shortened ; hence we 
find that in this strain a horse is unable to bring the heel of 
the foot to the gTound. This shortening, particularly during 
the early stages, is increased by the muscles being kept in a 
contracted condition, to relieve the inflamed part from tension ; 
but after a time descent of the heel is rendered an impossibility 
by adhesions and actual shortening from organic change in 
the non-active structures (the tendons and ligaments) of loco- 
motion. 

Symptoms. — There will be heat and swelling in the part; 
very often, during the earlier stages, the ligament can be felt 
swollen, prominent, and bulging, the tendons themselves being 
quite normal; when pressed upon, the horse evinces pain ; stands 
with the leg upright, and moves it stiffly, digging his toe into 
the ground. When in the hind leg, flexion is very imperfectly 
performed ; he seems to throw the limb behind him as he lifts 
it from the ground, and the fetlock and hock are not flexed as 
in sound action. When the tendons themselves are involved 
they will be found swollen upwards and downwards from the 
seat of the original injury; and this extension of the swelling 
prevents their gliding through their thecse, particularly the thecce 
situated in the carpal or tarsal fossse. 

To detect very slight sprains, especially if situated in a hind 
leg, it will often be necessary to compare the thickness of both 
legs by careful manipulation, as the swelling can only be de- 
tected in that way, on account of the coarse hair and thick skin 
of cart-horses' legs. In the better bred animal, a difference in 
the thickness can be easily seen as well as felt. 

The special treatment required for this lameness is the appli- 
cation of the high-heeled shoe, in order to throw the tendons 
into a state of relaxation, and a long period of rest. In chronic 



276 , PAKTICULAH LAMENESSES. 

cases, where shortening has permanently taken place, the opera- 
tion of tenotomy must be performed. 

Many horses with contraction of the tendons will perform 
very slow work moderately well if a piece of iron is attached to 
the toe of the shoe, projecting an inch or two in fronb of it, and 
slightly turned up at its anterior part. This acts as a lever 
upon the toe, forcing the heel downwards, and prevents " knuck- 
ling over " on the front of the fetlock-joint. 

Tenotomy, or division of the tendons, is performed as follows : — 
The animal must be cast with the lame limb lying undermost, 
which is to be detached from the hobble, and kept in a semi-flexed 
position by a cord placed round the fetlock. The operator must 
feel for the anterior edge of the tendon, a little below the middle 
of the leg. He then must introduce a small sharp-pointed scalpel, 
flatwise, through the skin and subcutaneous tissue, which occu- 
pies the space between the tendons and suspensory ligament, 
until its point touches the skin of the opposite side of the leg, 
keeping close to the tendon to avoid dividing the artery. The 
sharp-pointed scalpel is now withdrawn, and a probe-pointed 
tenotomy knife introduced in the same manner, until the probe 
point can be felt by the operator under the skin of the opposite 
side, when its edge must be turned towards the tendon, and the 
limb forcibly extended by an assistant. This extension will 
cause the tendon to press firmly on the edge of the knife, the 
operator at the same time cutting slowly towards the wound in 
the skin. The movements of the knife must be slow and 
cautious (or the skin may be wounded), until both perforans 
and perforatus are cleanly cut. In many cases it is found that 
tlie heel cannot be brought to the ground owing to the presence 
of old adhesions about the fetlock and pastern joints. These 
adhesions must be forcibly broken by powerful extension, such 
as by the operator placing his knee against the front of the horse's 
leg, and forcibly drawing the leg and foot forward until the 
adhesions give way. 

In performing tenotomy, a small wound is essential; for if 
a large one be made, a fungous growth springs up from it, 
which is difficult to remove, and which sets up the suppurative 
action, causes irritative fever, delays the healing process, and 
leaves an ugly blemish. 

The incision through the skin is always made in the fore leg 



SPEAIN OF FLEXOR TENDONS. 277 

on the inner side, and for the reason that the operator can 
better avoid dividing the artery. In the hind leg, it does not 
matter from which side the knife is introduced, for the artery is 
there, unless the operation be very low down, protected by the 
external small metatarsal bone. In aU cases the skin must not 
be wounded on the side opposite to that by which the scalpel is 
introduced. 

The after treatment is very simple, if the operation has been 
properly performed ; the wound may be pinned, the leg lightly 
bandaged, and occasionally moistened with tepid water; the 
horse's head tied to the rack for two or three days ; at the end 
of which time the wound will have healed. 

As a rule, I have aU the shoes removed before I perform an 
operation of this kind, and the feet rasped to as near their 
natural proportions as possible. This is important, as the lame 
foot is apt to be allowed to grow at the heel to an enormous 
extent. AU this overgrowth must be removed, or deformity of 
the leg wiU arise from it. 

In a few days after the operation, or in some cases immediately, 
if no adhesions exist, it wlU be seen that the horse brings the 
heel of the foot to the ground, and that the toe is turned up 
when he is made to move. This need not cause any apprehen- 
sion ; indeed, the only drawback to the success of the operation 
is the contraction of the new formation uniting the divided ends 
of the tendons, and the re-assumption of the form, to overcome 
which the operation has been performed. I always feel sure of 
a successful operation if the animal continues to walk upon the 
heel for some weeks afterwards, and I never apply a high-heeled 
shoe to such a case. 

The operation, although promising in itself, and successful in 
restoring the limb to its natural position, very frequently proves 
a source of disappointment, from the fact that the reparative 
material, which is thrown out between the ends of the divided 
tendons, gradually contracts, whereby the tendons are made as 
short as before it has been performed. In the hind leg this 
contraction is the usual consequence, and the tendency to it has 
to be overcome by a lever at the toe of the shoe. This often 
arrests, but seldom finally prevents it. In the fore extremity 
the operation is much more successful, the limb maintaining its 
natural condition for years afterwards. 



278 PAETICULAR LAMENESSES. 

There is generally an amount of thickening lelt in the leg ; 
but since this does not prevent the free use of the limb, it need 
not be iiiterfered with, as it gradually becomes absorbed, aad in 
the course of time the leg wiU look very respectable. 

A horse should not be piit to hard work for at least six months 
after the operation has been performed on a fore leg ; if on a 
hind leg he will require a much longer period. 



SPKAIN OF THE SUSPENSORY LIGAMENT. 

The superior sesamoidean or suspensory ligament is a broad 
strong band of white fibrous tissue, arising from the supra-pos- 
terior part of the canon bone, lying ia the hollow, bounded on 
either side by the small canon bones; it extends downwards, 
bifurcating above the fetlock, becoming attached to the lateral 
parts of the sesamoids, thence it is continued downwards and 
forwards to the tendon of the extensor pedis at the antero- 
inferior part of the os suffraginis, where its divisions become 
united, and are generally lost in the substance of that tendon ; 
but in the young subject a careful dissection generally shows 
that it again becomes divided, and that its two divisions travel 
along the lateral part of the os coronse, terminating there, and 
on either side of the pyramid of the os pedis. 

Much difference of opinion exists amongst veterinarians as 
to whether this ligament is elastic or not, — Percivall, Dick, and 
others maintaining that it is so; whilst the late Professor 
Barlow, from a careful investigation into its structure, argued to 
the contrary. 

I am quite convinced that the latter view is the correct one, 
and that the sesamoid bones do not descend and ascend during 
action in the manner described by Percivall, who says — " In 
proportion as the pastern is upright in position, less weight is 
imposed upon the sesamoid bones, more upon the pastern, and 
vice versa. What pressure or weight the pastern bone receives 
descends to the coronet, and then to the os pedis. But what 
becomes of the weight upon the sesamoids ? they have no bones 
below to transmit it to. They are in a somewhat similar 
situation to the splint bones; they call upon their attaching 
bands (their ligaments) to support them under their load, and 
their ligaments do so by yielding, they being elastic, so long 



SPRAIN OF SUSPENSORY LIGAMENT. 279 

as force is operating ; and the instant it is not, they, through 
their elasticity, again recover their short lengths, and so raise 
the sesamoid bones into their places. This descent and ascent 
of the sesamoids is not to be compared with that imperceptible 
and disputed motion of the splint bones ; on the contrary, it is 
a demonstrable and beautiful descending and ascending motion ; 
a playing up and down, after the manner of a spring of most 
elastic and exc[uisite workmanship, imparting at every step the 
horse takes its anti-concussive iniluence to every part of his 
frame. Watch the long and elastic fetlocks of the Arabian or 
race-horse as he is cantering upon turf, and at every bound he 
makes will the tufts of hair from those joints be seen dipping 
upon the ground, though, while the animal is standing still, they 
may be some inches removed from the surface; nothing can 
evince more beautifully and plainly than this the movements of 
the fetlocks. 

" The attaching band or ligament upon which the sesamoids 
repose in their descent, and depend for their re-ascent, is the 
suspensoi-y. And in order to show what proportion of the 
superincumbent weight these bones sustain, or rather how in- 
sufficient the pastern is without their aid to support the burden, 
we have only to cut the suspensory ligament through; that 
done, the horse is in real truth broken down; the feet slip 
forward and the toes turn up, while the fetlocks bend down 
upon the ground. Not so after division of the flexor tendons ; 
we occasionally sever them by way of remedy for knuckling 
over, and all that results in the enabling or forcing the animal 
to set his heel upon the ground. Once divide the suspensory 
ligament, however, and no power left is able to sustain the 
pasterns erect. The suspensory ligament is therefore one of 
the main-springs of the machine in action; one of the chief 
of those beautiful contrivances which, while they save the leg- 
bones from being smashed to pieces under the weight and shocks 
they have to sustain at every bound and leap the animal makes, 
insures his rider ease and safety to his journey's end." 

This quotation is very eloquent, but unfortunately the idea 
it conveys is incorrect in every particular. In the first place, 
the sesamoids do not sustain any part of the weight of the 
animal's body, being placed external to the bony skeleton, 
having no bones either immediately above or below, being, iu 



280 PAETICULAR LAMENESSES. 

fact, muscular appendages, like the patellce and naviculares, 
by which leverage power is given to the muscles whose tendons 
are inserted into or play over them. They are thus entirely 
different from the small splint bones, which bear concussion, 
being placed beneath other weight-bearing bones, and add to the 
bulk of the lower part of the knee, without increasing its 
weight to any great extent, which would be the case if the leg 
were in one piece; and by being attached by inter-osseous 
ligaments, not elastic ones, as Percivall maintains, deaden and 
modify concussion much more effectually than if the union were 
entirely bony. 

2d. The suspensory ligament is not to any extent elastic, and 
is for the purpose of keeping the sesamoids in their position 
to prevent their descent in the same way as the inferior suspen- 
sory ligament prevents their ascent during the movements of 
the tendons ; and also, by keeping the sesamoids firmly pressed 
against the fetlock-joint, it forms a brace or stay, which pre- 
vents over-extension of the fetlock and elevation of the toe, to 
which there is always a tendency from the pressure of the 
animal's weight. 

3d. The sesamoids do not descend and ascend, as described 
by Percivall, and even if the suspensory ligament were elastic, 
this movement in the bones would be an impossibility, since 
they are firmly attached to the tuberosities on the lateral aspects 
of the upper part of the body of the os suffraginis by the in- 
ternal and external lateral sesamoidean ligaments, and to each 
other by the inter-osseous. In fact, they are pulleys, over 
which the tendons play like ropes, enabling them tlie more 
easily to lift the feet from the ground. 

How is it, then, that the fetlock pad comes nearly to the 
ground at every stride of the race-horse ? It is because the 
whole limb is pressed downwards upon the fetlocks, pastern, 
and coffin bones, which are placed obliquely under the animal's 
body ; and this seeming descent of the sesamoids is simply an 
increase of this obliquity. 

Dissections, and observations on the limb of the Hving animal, 
have convinced me that extension at the fetlock-joint is very 
limited, and that it is an impossibility to increase the obliquity 
of the pastern, even by very great pressure upon the fetlock- 
joint, while the suspensory ligament is uncut, and that the in- 



SPRAIN OF SUSPENSOEY LIGAMENT, 281 

crease of obliquity whicli is seen during rapid action is due to 
the movements of the os coronse on the pedal bone, the articula- 
tion between them admitting of extension to a much greater 
degree than any of the other phalangeal articulations. If it 
be carefully noted, the movement between the os suffraginis 
and metacarpal is almost confined to flexion ; that between the 
suffraginis and coronse very limited in every way ; whilst the 
formation of the inferior articular extremity of the os coronse 
and the articular surface of the coffin bone admit of both 
flexion and extension, the first movement being more limited 
than the latter. To prove this by analogy, let the experi- 
mentalist press a table with the bulb of his finger, and it will 
be seen at once that the distal is much more capable of ex- 
tension than the rest of the phalangeal articulations. The 
comparison is a good one, as the articulations of the human 
fingers and those of the pastern of the horse are very much 
alike. It is a necessity to the well-being of the animal that 
the greatest adaptability to extension should be at the ex- 
tremity of the limb, as the greatest pressure is there ; in fact, 
the pastern is a lever, extending from the fetlock to the foot, 
and the greater the length it has, the more oblique it will be. 

The limb not only descends at the pastern during motion, 
but it also ascends at the shoulder, where the body is suspended 
upon it by the seratus magnus and other muscles. We have 
thus a spring below and a spring above, — a wonderful and 
beautiful provision to destroy the effects of concussion, which 
would be fatal to the animal' when all the weight of his 
body is thrown upon the fore extremity during galloping or 
jumping. The hind extremity, unlike the fore one, is attached 
to the trunk by means of an articulation — the hip-joint — be- 
cause the forces that produce concussion are not applied to it 
in the same degree as to the fore one ; the impulse of rapid 
pace throwing the weight from the hind upon the fore extremity; 
hence it is that one spring, namely, the inferior one, is 
sufficient. 

The suspensory ligament being to all intents and purposes 
inelastic, and the sesamoid bones firmly bound to it, to the 
fetlock, and to the pastern, assists in supporting those parts of 
the limb which are below it, namely, tJie pastern and the foot, 
by forming a brace or stay, exactly in the same way as a 



282 PARTICULAR LAMENESSES. 

rope fixed in like manner would do. Without this aid, the 
power of the flexor muscles would be quite insufficient for the 
purpose, and without the suspensory ligament the horse's toes 
would be turned up, particularly while the muscles were in- 
active ; but with its assistance they are enabled to obtain that 
repose which is so essential to the well-being of all muscular 
tissue. 

Nothing proves this staying or bracing function of the sus- 
pensory ligament and sesamoids so much as rupture of the 
ligament or fracture of the sesamoid bones. Immediately after 
these accidents, the toe of the foot is turned up ; even in such 
a case the sesamoids are not moved from their position, but the 
fixed points of the stay are destroyed. 

Sprain of the suspensory ligament is of two kinds, namely — 
(1.) An inflamed condition arising from slight causes ; and (2.) 
Eupture, partial or complete, from more violent ones. 

In the first form there will be lameness ; swelling felt along 
the course of the ligament ; the animal standing and walking on 
his toe as much as he can, to remove all tension from the liga- 
ment ; but in the latter form the fetlock pads descend more or 
less, depending upon the gravity of the lesion. 

The rupture may be completely through the substance of the 
ligament, above its bifurcation, or one of the branches only may 
be lacerated, above its attachment to the sesamoid bone ; or it 
may be detached from the bone without transverse rupture. 

This lesion occurs both in the fore and hind extremities ; in 
the fore extremities of race-horses and hunters, and more com- 
monly in the hind ones of horses which draw heavy loads. It 
may be in one or in both legs at the same time. I have often 
seen it in both hind legs of 'bus horses in hilly districts. 

The symptoms are descent of the fetlock pads, turning up of 
the toes, with heat and swelling of the leg or legs. The lame- 
ness is often very great, the animal being almost unable to 
move. 

The injury is a very serious one ; but with a long rest and 
proper treatment a horse so injured may become sufficiently 
sound to perform moderate work for many years. Yet there 
is always a weakness left, which must be considered an un- 
soundness, as it may at any time cause lameness, particularly if 
the animal be called upon to do a little extra worli. 



SPRAIN OF SUSPENSORY LIGAMENT. 283 

The marks of the lesion always remain in the shape of a 
thickening, which may be felt close to the large canon bone, or 
upon any part of the course of the ligament. 

Special Treatment. — Patten shoe or shoes, if they can be 
applied and borne ; firm pledgets of tow placed in the hoUow of 
the heel to support the fetlock, maintained in their position 
by firm bandaging. The tow should be made into a firm roU, 
the fetlock pad elevated by an assistant, the roll of tow placed 
under it so as to completely fill up the hollow of the heel, and 
fixed in that position by a bandage. Other bandages should 
be placed round the leg as high as possible, to keep the parts 
together, and thus diminish the breach to be healed; cold 
applications applied until the inflammatory symptoms have 
subsided, and the parts firmly reunited, when a blister may be 
rubbed on to remove the thickening which remains. A lono- 
rest is essential, and if the patient wUl not lie down the slings 
are to be used. 

In some cases of injury to the foot, the absorbents of the leg 
become swollen and inflamed. This must not be confounded 
with tendinous or ligamentous injuries. 



SPRAIN OF THE FETLOCK-JOINT. 

The fetlock-joint is liable to inflammation of its synovial 
membrane from a variety of causes, the most frequent being 
sprain of one of its lateral ligaments. In comparison with 
other forms of lameness, this is rare, though, from the fre- 
quency of fracture of the upper extremity of the os suffraginis, 
entering into the composition of the joint, one would be in- 
clined to conclude that the concussion which so often produces 
fracture would, when applied in a more hmited degree, be a 
frequent source of inflammation ; but such is not the case. It 
may be here observed that squareness of the fetlock, obtained 
by weU-developed tuberosities on the os suffraginis, is much to 
be desired, a round fetlock being very objectionable. At the 
same time, it must be remembered that their very squareness 
renders them more liable to fracture, because the large upper 
extremity of the suffraginis in a square fetlock is, as it were, mi- 
supported by the body of the bone. 

In inflammation of the fetlock-joint, from whatever caiise. 



284 PARTICULAR LAMENESSES. 

the lameness is characterised by, on the part of the animal, 
inability to flex it, by heat, swelling, pain on pressure, and 
more or less pointing of the foot. 



SESAMOIDITIS. — INFLAMMATION OF THE SESAMOID BURSA. 

The posterior part of the sesamoid bones is covered by carti- 
lage, forming a groove, over which the flexor perforans plays. 
Both the cartilaginous pad and the tendon are liable to injury, 
which causes severe and qbstinate lameness. 

Sesamoiditis may also arise from an injury to the inferior part 
of the suspensory ligament — whether involving it above the 
bifurcation or confined to one branch only — ^by extension of the 
inflammation ; and is oftener met with in hunters than in any 
other class of horses. 

Sesamoiditis is not so often found in the fore as in the hipd 
extremity, and is rather difficult to diagnose, owing to the 
accompanying swelling being very limited in extent. 

The pathology is as follows : — 

1st. Inflammation of the bursa, owing to sprain or other' 
injury. 

2d. Increased secretion into the synovial cavity, causing a 
bulging of its capsule upon either side of the flexor tendon. 

3d. Ulceration of the cartilage of incrustation, softening and 
laceration of the fibres of the tendon, and, finally, adhesion 
between the bones and tendon, 

Ath. Wlien arising from sprain of the suspensory ligament 
there wUl be thickening of the ligament or of one of its branches, 
associated with that loss of cohesion in its structure which seems 
so characteristic of inflamed ligament, as manifested by the 
animal going upon the heel, and descent of the fetlock pad. 

Symptoms. — Lameness, the horse, unless the suspensory liga- 
ment be involved, going on his toe; heat at the back of 
the fetlock, with swelling of the bursa. This swelling is diffe- 
rent in its character from a mere dropsy of the fetlock joint or 
sheaths of the tendons ; in sesamoiditis, although it fluctuates 
upon pressure, it feels tense, the capsule being fully distended 
with fluid; whereas in a common wind -gall it is soft, and easily 
pressed from one side of the leg to the other. This difference 
in the character of the two enlargements must be remembered. 



INFLAMMATIOX OF THE SESAMOID EUESA. 



285 



The hard enlargement of sesamoiditis is an unsoundness ; the 
soft yielding swelling constituting wind-galls is never reckoned 
as such. 

This bursa is often the seat of rheumatism. 

There is a speciality about this lameness which Professor 
Dick was very particular in describing, namely, that a horse, 
after a period of rest, may trot quite sound for a short time ; 
that he is liable to fall lame again with very moderate work ; 
and that the lameness is most obstinate to remove. 

An injury to the inferior part of the suspensory ligament, 
whether involving it above the bifurcation, or confined to one 
branch only, may cause sesamoiditis by extension of the inflam- 
mation; but, as a rule, it is due to sprain of the tendon or 
injury to the cartilage of incrustation. 

The special treatment consists in 
the application of a high-heeled shoe, 
and if the lameness be in a hind 
limb and very severe, placing the 
animal in slings, and the constant 
application of cold water. After the 
subsidence of the inflammation, the 
absorption of the enlargement is best 
effected by the use of Mr. Broad's 
truss. 

The inferior suspensory ligaments 
of the sesamoid bones are occasionally 
sprained, causing great lameness, the 
animal going on the toe, with swelling 
in the hollow of the heel. 

In some rare instances, the liga- 
mentous structures in this part of the 
limb have been converted into osseous 
material (osteophytes), forming com- 
plete rings round the tendons. — (See 
Photo-lithograph, Plate I., Fig. 4.) 




Fro. 44.- 
sliown at a. 



-False ring-bone, 



EING-BONES. 



This term is applied to the osseous deposits which are 
found upon the upper and lower pastern bones, but with. 



286 



PAETICULAR LAMENESSES. 



more propriety to those whicli take tlie form of a ring round 
the bone. 

Ring-bone is of two kinds, true and false. The false ring- 
bone may be dismissed in a few words ; it is an exostosis, 
situated about the middle of the os suffraginis, due to an in- 
creased development of one or both of the roughened ridges on 

this bone, which 
give attachment to 
the sesamoidean 
ligaments. When 
very large, it may 
cause lameness; as 
a rule, however, it 
never gives incon- 
venience to the 
animal, and is not 
always to be look- 

^ ^t^^^k'^SS^ ^^kI^J ^^ upon as a cause 

of unsoundness. It 
may be compared 
to a splint thrown 
out for some bene- 
ficial purpose. 

The true ring- 
bone is quite an- 
other matter, and 
is an unsoundness 
in every sense of 
the word, involv- 
ing important arti- 
culations, and giv- 
ing rise to obsti- 
nate, and often in- 
curable, lameness. 
There are two 

'.kinds of true ring-bone, the high and the low ; it is called high 
when it involves the proximal inter-phaJangeal articulation or 
pastern joint ; and low, when it involves the distal inter-phalan- 
,,geal articulation or coffin joint. In many instances both forms 
exist at the same time. Photo -lithograph, Plate III., Pig. 5, is 
a good illustration of this. 




Pig. 45. — High ring-bone. 



EING-BONES. 



287 



Eing-bone must not be confounded with what is termed side- 
bone ; the first is a bone disease, the second a disease of fibro- 
cartilage. 

Eing-bones, whether high or low, 
vary in size ; but the degree of lame- 
ness does not depend upon the mere 
size of the new formation. An animal 
may be very lame, indeed, with hut 
little osseous deposit; and another 
may show but little lameness, with a 
very large ring-bone. 

Very often the segment of the ring 
is defective, and the deposit may ap- 
pear only on one surface of the limb, 
or on both sides without any promi- 
nence in the front. When at the 
sides, they do not cause the same de- 
gree of lameness as when the front is 
involved. 

Eing-bones are not the cause, but 
the result of disease, being the effect 




Pig. 46. — Lowering-bone. 



of an inflammation originating in the 
extremities of the bones, or synovial 
membranes of the articulations which 
they involve. As a rule, they are the 
result of ostitis, commencing in the 
cancellated structure of the bones, the 
areolae of which first became filled 
with an organizable lymph, convertible 
into bony material, as already de- 
scribed. — (See Ostitis, p. 151.) During 
the progress of the inflammation, the 
articular cartilage and laminal laye 
of the end of the bones become re 
moved by absorption, while external 
to the joint active deposition of bonj 
material is going on, for the purpose 
of repairing the damage within. 

In some instances the disease may commence at the inferior 
extremity of the os suffraginis, and gradually involve the 




Fig. 47. 



288 PAETICULAR LAMENESSES. 

articulation and os corouae. The accompanying figure (Fig. 47) 
illustrates this. When involving either articulation, ring-bone 
always causes lameness at its commencement ; but when anchy- 
losis is completed, such lameness may almost, if not entirely, 
disappear. 

The lameness of ring-bone precedes the deposition of bony 
matter, and is due to the presence of inflammation in the bones 
or synovial membrane. 

The gait of a horse lame from this cause is characteristic. 
If in the fore extremity, except the deposit be on the posterior 
aspect, the patient puts his heel to the ground first ; but when 
in the hind pastern, the toe touches the ground first always 
when it is situated in the upper position, except it be in front ; 
when in the lower position, the heel comes down first. From 
this peculiarity in putting the foot to the ground, it is apt to be 
confounded with laminitis, seedy-toe, and inflammation of the 
coronary band. It differs from laminitis by the absence of pain 
at the toe, freedom from fever, &c., and by the heat being con- 
fined to the upper part of the foot only. 

An examination of the foot wUl determine whether there be 
a seedy-toe or a sand-crack in its front ; and the absence of the 
striated appearance of the wall of the foot wiU. distinguish it 
from inflammation of the coronary substance. 

PercivaU, writing in the year 182.3, has thus classified 150 
specimens of ring-bone. He, however, includes anchylosis of 
the fetlock-joint under the term : — 

5 complete anchyloses of the fetlock -joint. 
40 „ „ „ pastern-joint. 

18 „ ,. „ coffin-joint. 

The other specimens were simply encrusted, more particularly 
around their extremities, with layers of new bone, or were 
variously deformed with exostoses of diff'erent shapes, many of 
which were very large, and several of them confined to one side. 

My own observations upon, and examinations of, specimens 
enable me to agree with Percivall, and to differ from Professor 
Dick and others, who maintained that the lower form was the 
most common. 

The causes of ring-bone are hereditary, structural, incidental, 
and rheumatoid. 

Hereditary predisposition is sufficiently proved and acknow- 



RING-BONES. 289 

ledged; I therefore simply advise breeders of horses never to 
breed from a sire or dam having ring-bones, unless their origin 
can be readily traced to some accidental cause. 

The structural tendency to ring-bone is manifested in horses 
witli upright pasterns. PercivaU explains this in nearly the 
following words : — 

" The pastern and coffin bones constitute the nethermost 
parts, the pedestals of the columns of bones composing the 
limbs ; and being so, they receive the entire weight and force 
transmitted from above. The pastern, when long and oblique 
in position, receives the superincumbent weight in such an 
indirect line that, bending towards the ground with the fetlock, 
nothing like jar or concussion follows. The very reverse of 
this, however, is lil^ely to happen every time the foot of a limb 
having a short and upright pastern comes to the ground. In 
it, instead of the weight descending obliquely, it descends 
directly upon the pastern bones, making them entirely depen- 
dent upon the pedal bone for counteractive spring ; and should 
anything occur to destroy or diminish this spring, or to throw 
more weight, or weight more suddenly, upon it than it can 
counteract, jar of the whole apparatus ensues ; and an effort of 
nature to strengthen the parts, by investing them with callus 
and ossiiication, is likely to be the ultimate result. For we 
would view ring-bone, disease though it most assuredly must 
be called, frequently in young horses, as a resource nature 
seems invariably to adopt whenever the pastern bones and 
joints are found unequal to the exertions or efforts required of 
them. And the reason why ring-bone occurs oftener in the 
hind than in the fore limb wiU probably be found in the greater 
stress or strain the hind pasterns undergo in unbacked young 
horses, particularly in such acts as galloping, jumping, ' &c., 
exercises which they are likely to take of their own accord 
while running out at pasture." 

In the treatment of ring-bone care must be taken to observe 
how the patient places the foot on the ground. In the fore leg 
he always puts the heel down first, in order to throw the weight 
of his body, and the consequent concussion from the column of 
bones, on to the soft parts. In such a case a thin-heeled bar- 
shoe must be put on the foot — the shoe recommended by my 
friend Mr. Broad of Bath for laminitis. This gives gxeat relief 

u 



290 PAETICULAE LAMENESSES. 

by allowing the animal to throw its weight upon the heels 
with the least possible effort. I have many cases of riag-bone 
at the present time, where the horses go moderately sound with 
puch a shoe, that would be unworkably lame if shod in the 
ordinary way. 

If the horse walks on his toe, he must be shod with a high- 
heeled shoe. This only occurs when ring-bone is situated in the 
hind limbs, and on the sides or back of the pastern ; when in 
front, the horse will go on his heel, and is to be shod with the 
low- heeled shoe. 

Very long pasterns, from the fact that they act too powerfully 
as levers upon the articulations, are subject to ring-bones; in 
such cases, I think that they arise from sprain of the ligaments. 
This occurs, as a rule, in the hind legs, and for this reason, the 
horse lame from this cause throws his weight upon the column 
of bones by walking on the toe. Sprain of the flexor tendons, 
as well as that of the suspensory ligament, both in the fore and 
hind limbs, are often succeeded by ring-bones. 



CHAPTEE XV. 

PARTICULAR LAMENESSES — continued. 

HIP-JOINT LAMENESS SPRAIN OF GLUTEAL TENDONS, OR TROCHAN- 
TERIC LAMENESS SPRAIN AND ATROPHY OF CRURAL MUSCLES 

STIFLE-JOINT LAMENESS LACERATION OF FLEXORr METATARSI 

MUSCLE. 

HiP-JoiNT lameness is of very rare occurrence, except as a result 
of the scrofulous diathesis in young animals, and of rheumatism 
in those of mature age. Sprain of the hip-joint is very rare 
indeed, but it is possible ; and when inflammation of the joint 
occurs from this cause, the same pathological changes are 
observed as in other joints, namely, redness of the synovial 
membrane, exudation into the cavity, and if not arrested, ulcera- 
tion of the articular cartilage and laminal layer of the bones. 
In rheumatoid disease, the tendency is to the formation of the 
porcellaneous deposit within, and bony vegetations around, the 
articulations. 

Lameness in the Mp, however, is not at aU an unfrequent 
occurrence ; still its seat is not the joint, but the head of the 
trochanter major of the lemur. 

" The trochanter major is a very large eminence which looks 
outwards and upwards, and presents, posteriorly, a prominent 
part, termed the summit, which stands a little higher than the 
articular head (of the femur), and gives attachment to one of the 
heads of the gluteus maximus; and anteriorly the convexity, 
which is rounded and covered externally by cartilage of incrus- 
tation, which forms a bursa, over which plays the other tendon 
of the gluteus maximus, which becomes inserted into the ridge 
just below." — (Steangeways' Anatomy) 

The above quotation wiU enable the reader to understand that 
the trochanter major is a very important protuberance ; that it 



292 



PAETICULAK LAMENESSES. 



is a very strong lever, to which the tendons of powerful muscles 
are attached ; that it has to assist extensive movements, and, in 
accordance with the importance and extent of its functions, it is 
liable to injury and disease. 

Sprain of the tendon of the gluteus maximus gives rise to 
inflammation of the synovial bursa on the convexity of the 
trochanter, as well as in the substance of the tendon. The 
sum'mit is liable to injury from blows or falls, and the inflam- 
mation so produced extends to the convexity. From whatever 
cause the inflammation arises, and whether it originates at the 

summit or the convexity of the 
trochanter, the exudate which is 
formed is apt to be converted 
into osseous material, and the 
cartilage of incrustation on the 
convexity to be removed by ul- 
ceration. — (See Fig. 48.) 

Violent inflammation of the 
hip-joint is accompanied by very 
severe symptoms ; and the animal 
will stand almost immoveable, 
with the foot raised from the 
ground, in which position it will 
be steadily maintained, unless 
he is forced to move; all move- 
ment increasing pain to an agon- 
ising extent. There will be 
fever, loss of appetite and flesh, 
rapid wasting of the quarter, and 
inability to lie down. In such a 
case the animal must be slung. 

The dissection of such cases 
generally reveals ulceration or la- 
ceration of the ligamentum teres, 
m^or,-det'S?dTtLtL^^''"*" ^l«eration of the articular carti- 
> lage, both on the head of the 

femur and cotyloid cavity, with suppuration into the cavity of 
,v the joint, or partial destruction of it by a deposition of bony 
*4,;,matter. I have never witnessed anchylosis of this joint, but I 
■'5, have a specimen where the acetabulum is almost fiUed with 




HIP-JOINT LAMENESS. 293 

bony material. If the severe symptoms do not soon abate, 
the practitioner will understand that the above pathological 
changes are going on, and that the horse will remain incurably 
lame. 

The symptoms of a milder form of hip-joint lameness, and 
of that arising from disease of the trochanter, do not differ in 
any peculiarity of gait. Tliere is a hoja and a catch in the lame 
limb, and a want of movement in the quarter, which to a prac- 
tised eye is quite suggestive. The whole of the quarter on the 
lame side is elevated with as little motion of the hip as possible; 
the other articulations being flexed with ease. "While standing, 
the foot of the lame Kmb in severe cases will often be elevated 
from the ground ; the muscles below the seat of disease exert- 
ing themselves, as it were, to support the weight, and thus 
allowing the gluteals to be in a state of relaxation. In hip- 
joint lameness heat may be felt, and pain caused, in some cases, 
by pressure applied per rectum. In trochanteric lameness, a 
distinct swelling can be detected, both by touch and sight, 
upon the quarter. In both forms, atrophy of the muscles of 
the quarter soon manifests itself, and is apt to lead the prac- 
titioner to confound the disease with fracture; but in disease 
the wasting and inequality of the quarter appear after the 
animal has been lame for some little time, whilst in fracture 
they are seen immediately after the displacement of the bones. 

The swelling of trochanteric lameness is of an irregular 
roundish shape, on the very point of what is erroneously called 
the hip-joint ; hot to the touch, and painful upon pressure. To 
see it distinctly, the practitioner should stand both behind and 
at the side of the patient, as the shades of light sometimes hide 
it from observation. 

In the treatment of either form, the high-heeled shoe is 
to be put on the foot, to enable the parts to be maintained in 
a state of repose. The patient requires a long rest, since the 
lameness is very apt to return ; and in this, as well as in other 
lamenesses, treatment should be resorted to, and rest imposed, 
before alteration of structure has taken place. Even when all 
signs of lameness have disappeared, great care must be taken 
not to work the animal too soon. 

The horses most subject to this lameness are those which draw 
heavy loads, and care must be taken that they are not forced 



294 PABTICULAK LAMENESSES. 

to this too soon after apparent cure, or it will most assuredly 
cause a return of the lameness. Another fact should be remem- 
bered, namely, that a high toe-piece on the shoe, by increasing 
the resistance to the action of the muscles of the limb, may cause 
this, as well as manv other forms of lameness. 



SPEAIN AND ATEOPHY OF THE CEUEAL MUSCLES. 

That mass of muscular structure laiown as the crural muscles 
is liable to sprain. It consists of the rectus femoris, arising from 
the ilium ; the vastus extemus and internus, arising from the 
superior part of the femur ; and the crureus, arising from the 
lower half of the femur. Their muscular structure is very 
intimately blended, and they finally become inserted into the 
superior surface of the patella. Their action is to extend and 
elevate the thigh, and advance it under the body. 

The symptoms of injury or sprain of these muscles are inability 
to extend the stifle and flex the hock, in fact to draw the limb 
forward ; dragging of the toe when the patient moves ; when 
standing still, the patella seems to have slipped down, and 
there is knuckling over of the fetlock-joint, the whole limb 
being posterior to its fellow. After a time the muscular struc- 
tures become atrophied, individual muscles become prominent, 
and a concavity presents itself between the anterior spine of the 
ilium and the patella, and this atrophy is seen most markedly 
after azoturia. 

Since the introduction of tramways, this form of injury has 
become more common, owing to horses slipping on the rails. 
This form of lameness requires long rest. 



STIFLE-JOINT LAMENESS 

Is of two kinds, namely, that within the joint proper, involv- 
ing the condyles of the femur, the semi-lunar discs, and articular 
head of the tibia (see Photo-Uthograph, Plate II., Fig. 3) ; and 
that in the patella articulation. The pathology of both forms 
is aKke — iaflammation, ulceration of the articular cartilage and 
t of the semi-lunar discs, when the joint proper is involved, of the 
li^i deposition of the porcellaneous deposit, both in the cartilage and 
Haversian canals of the bones, when caused by rheumatoid disease. 
In stifle-joint lameness, the limb, when the animal stands, 



STIFLE-JOINT LAMENESS. 295 

is generally bent, the thigh flexed upon the pelvis, and the 
leg upon the thigh, so that the articular surfaces of the hones 
are separated, and prevented from pressing against each 
other; but when made to move, the relative positions of the 
various bones are altered, and, instead of being ilexed, the 
stifle is maintained in a rigidly extended state. In this 
manner the joint is locked, its movements suspended, and, as 
a result, the heel of the foot touches the ground first. This is 
more especially the case when the posterior part of the joint is 
diseased. 

In lameness from disease of the bursa-patellse, the horse 
generally walks with his toe dragging the ground, as if he 
were afraid to bring the rectus femoris and vasti muscles into 
action to elevate the patella on the trochlea of the femur ; the 
forward movement of the limb being performed with great 
difficulty, the toe of the foot describing the segment of a circle 
at each step. These symptoms are, however, not constant; 
some cases of well-marked patella lameness put the heel to the 
ground first. But in aU instances the position while stand- 
ing is that of semi-flexion, this being the best calculated to 
insure separation of the various articular surfaces, and prevent 
pressure. 

Dissection of stifle-joint lameness reveals a condition of in- 
flammation of the synovial membranes, of the condyles of the 
femur, and the articular head of the tibia; degeneration into 
shreddy masses of the semi-lunar discs, laceration of their liga- 
ments, removal of the articular cartilage, or its calcification and 
removal by friction. 

When confined to the bursa-pateUaj, the alterations of struc- 
ture consist in the removal of the articular cartilage from the 
patella and trochlea of the femur, and thickening of the synovial 
membrane from interstitial inflammatory exudation. 

The bursa-patellse is situated superficially, and when in- 
flamed the increased secretion poured into it causes a swelling 
in front of the joint. This swelling must not be confounded 
with an apparent enlargement of this part, seen in the healthy 
stifle when the animal stands with the limb in a semi-flexed 
easy position, when "he stands resting it," as it is commonly 
called. The swelling arising from disease is persistent, hard, 
and prominent when the limb is extended; but the enlarge- 



296 PAETICULAE LAMENESSES. 

rnent arising from the parts being thrown into a state of rest 
and relaxation is soft, and disappears when the horse is made to 
stand firmly. 

Professor Dick said that stifle-joint lameness could he detected 
by pressing upon either side of the internal lateral ligament, and 
that a swelling could be felt caused by the distension of the 
capsular ligament with synovia. I have never been able to con- 
firm this, and have been compelled to be satisfied with negative 
symptoms and the gait. 

Relaxation of the patella arises from sprain and inflammation 
of the lateral ligaments, which thus become elongated and allow 
of partial dislocation of the patella. The symptoms and treat- 
ment are similar to those recommended for luxation (described 
at page 143, which see). 

The muscles of the stifle are subject to aramp, the symptoms 
being very similar to those of dislocation of the patella, the 
limb being extended and fixed to the ground. It is also often 
seen in dogs. It comes on and goes off suddenly. I have 
known such to arise from indigestion, and the liability to its 
return to be completely removed by one or two doses of 
purgative medicine and alteration of diet. 

Subcutaneous laceration of tJie flexor metatarsi muscle is occa- 
sionally a cause of lameness. Professor Dick had seen some- 
thing of it. He used to refer to it in his lectures as presenting 
symptoms similar to paralysis of the gastrocnemii. He used to 
say that when the flexor metatarsi muscle, any muscles situated 
at the anterior part of the stifle or the gastrocnemii were injured, 
the tendo-achilles fell into a relaxed condition when the limb 
was elevated from the ground. 

Figure 49 is from life, drawn by Professor Vaughan, when 
a student of the College. The horse was an ill-looking 
long-legged cart-horse, very subject to rheumatic attacks, for 
which Mr. Cunningham of Slateford had repeatedly attended, 
him. Towards the end of 1871 he was found one mornjagro 
be very lame, and when he attempted to move, the r/^^ hind 
leg was thrown upwards and backwards with great violence ; at 
the same time the tendo-achilles was seen to fall into a num- 
ber of folds. Upon the limb being elevated by the hand, the 
same seemingly powerless condition of the gastrocnemii was 
observed. The limb was swollen above and in front of the 



LACERATION OF FLEXOR METATARSI MUSCLE. 



297 



hock, midway between it and the patella. The horse being old 
and not of much value, the owner, at the suggestion of Mr. 
Cunningham, sent him to the College for dissection, M'hen it 




Fig. 49. 

was discovered that the flexor metatarsi was lacerated across 
its whole thickness, at a point corresponding to the external 
swelling; its fibres were pale, and when examined under the 
microscope their tranverse striae were nearly, and in some 
places entirely, absent, showing that the sarcous elements were 
undergoing degeneration. I have met with other instances of 
the same lesion, but never had the opportunity of making a dis- 
section of the parts prior to this. As to the probaljility of 
repair, I think that, provided the animal be not too old, the 
chances of recovery are very good, and that in the course of 
time reunion of the divided muscle may be expected; but 
should the horse be old, or of a weak constitution, the pro- 
babilities are that the rupture is a result of degenerative 
disease of the muscular tissue, and not a mere accident, and 



298 PARTICULAB LAMENESSES. 

that the process of repair will be very doubtful and unsatis- 
factory. 

Tliis peculiar lameness is not always due to rupture of the 
flexor metatarsi muscle, as in the case just described, for it some- 
times happens that its tendons of insertion become detached from 
the tarsal and metatarsal bones. Such cases are diagnosed by 
the peculiar gait and the seat of the swelling. 

Some few years ago there were three cases of sprain of this 
muscle in Edinburgh at the same time, two in the OoUen'e 
practice and one in Mr. E, Eutherford's. 



CHAPTER XVI. 

PARTICULAR LAMENESSES — continued. 

DISEASES OF THE HOCK BOG-SPAVIN BONE-SPAVIN CONFORMATION 

OF HOCK MOST SUBJECT TO SPAVIN — THOROUGH-PIN CAPPED 

HOCK INJURIES TO GASTROCNEMn MUSCLES CURB. 

DISEASES OF THE HOCK. 

The tarsus or hock corresponds to the ankle-joint of man. Its 
diseases may be divided into three classes, namely— (1.) Dis- 
eases of the true hock-joint (that composed of the tibia and 
astragalus); (2.) Diseases of the gliding articulations formed by 
the cuneiform bones ; and (3.) Diseases of its ligamentous and 
tendinous structures. 



I. DISEASES OF THE TRUE HOCK-JOINT. 

Bog-Spavin. — ^A bog-spavin, when caused by inflammation of 
the joint, is a tense, fluctuating swelling, accompanied by heat 
and pain. In such instances it is an unsoundness indicating a 
change within the textures of the joint. There are bog-spavins, 
however, which may not be looked upon as constituting unsound- 
ness, being mere dropsy of the articulation, arising from some 
fault of conformation. Professor Dick maintained that such 
collections were " mere stores of synovia for lubricating the joint, 
thus proving the best preventatives of disease, by preventing 
friction." These kinds of bog-spavins are most frequently found 
in very upright or in veiy crooked hocks, and in weak hocks of 
any description ; because in aU these forms concussion is most 
severely felt, and exertion is likely to be injurious. In all 
probability the hyper-secretion of synovia is due to some 



300 PAETICULAE LAMENESSES. 

irritation not amounting to actual disease, and may be viewed 
as a provision of nature to fulfil the purposes ascribed to it by- 
Professor Dick, since it often happens that such hocks remain 
sound as long as those of a better conformation. They should, 
however, be looked upon with suspicion, and the practitioner 
ought at all times to satisfy himself by a severe trial that such 
hocks are able to bear a reasonable amount of exertion ; that the 
swelling does not increase after such test, and that the animal 
be neither stiff nor lame in the slightest degree. 

Inflammation of the trae hock- joint may be acute or chronic. 
In the acute form the lameness is very great, with fever, loss of 
condition, and inability to put the foot to the ground. It is apt 
to terminate in ulceration of the articular cartilage and a partial 
anchylosis of the joint. 

A very constant condition of the joint in the chronic form 
of bog-spavin, and probably the cause of it, is the gradual con- 
version of the articular cartilage into calcareous matter — the 
ivory or porcellaneous deposit.: — (See Photo-lithograph, Plate 
II., Fig. 5.) This condition is associated with the rheumatoid 
diathesis ; and not only is there a deposit in the cartilage, but 
also in the synovial fringes, which are converted into hard 
rounded nodules of calcareous matter. Common inflammation 
of a joint generally tends to ulceration and anchylosis ; the rheu- 
matoid, to calcification of the articular cartilage and synovial 
fringes. 

The sulci of the hock-joint should not be confounded with 
ulcers. 

When articular cartilage has been calcified, or converted into 
the ivory-like deposit, it no longer prevents the effects of the 
friction arising from the movements of the bones upon each 
other. A careful examination of Photo-lithograph, Plate 
II., Figs. 3 and 5, will at once demonstrate this, for it will be 
seen that the articular heads of the bones are worn down, 
leaving well-marked, and, in the hock, deep grooves upon 
them. The polished appearance given to the diseased part 
was attributed by Professor Dick to the effect of friction on 
bone otherwise unchanged; but a more careful examination 
has shown that it is due to an actual formation of a very 
hard, earthy matter in the Haversian canals, for the purpose 
of counteracting and limiting the effects of friction,- and that 



DISEASES or THE HOCK. 301 

its glistening, poUslied appearance is undoubtedly due to the 
friction. 

"What is termed a Mood-spavin is simply a distended con- 
dition of the vena-saphena, caused hy the pressure of a bursal 
or bony enlargement. It has been described as a disease of 
the vein, and in some rare instances a varicosity has actually 
existed. 

In rheumatoid diseases of the hock-joint, the crackling sound 
caused by the first movements of the articulation, already 
described, has been noticed by some veterinarians. Thus, the 
late Mr. Parrel of Dublin was able to prognosticate the 
incurability of hock-joint disease when it was accompanied 
by that sound. 

What is commonly called a " sprung hock" is an enlarged and 
inflamed condition of the tarsus generally, involving the struc- 
tures of the whole articulation, arising from severe sprain, and in 
some instances associated with fracture of one or more of the 
smaller bones. 

This injury causes extreme lameness, and fever ; prevents the 
animal from lying down and taking its natural rest ; and is 
thus a cause of rapid loss of condition, and sometimes of death. 

The special treatment is that calculated to allay irritability, 
fever, and the local pain; and in order that the animal may 
obtain some degree of rest the slings are essential ; and when 
the acute symptoms have subsided, repeated applications of the 
biniodide of mercury ointment to stimulate the absorption of 
the callous enlargements, and perhaps setoning or the actual 
cautery to remove any remaining lameness. 

11. DISEASES OF THE GLIDING AKTIGULATIONS OF THE HOCKS. 

Bone-Spavin. — Bone-spavin is a very common cause of lame- 
ness and unsoundness, and it is of importance that a veterinary 
surgeon be a good judge of a hock ; for what may be a spavin in 
one horse may be a mere peculiarity of conformation in another. 

Definition.— The derivation of the word spavin is buried in 
obscurity; but it is thought by some to be derived from the 
Italian spavenio, a disease of horses— an unsatisfactory ex-' 
planation. I find, however, that Eokitansky describes a lamellar 
bony tumour as "spavined;" possibly the word may have some 
connection with that form of exostosis. A bone-spavin may be 



302 



PAETICULAR LAMENESSES. 



defined to be an exostosis on the inner and lower part of the 
hock, arising from inflammation of the cuneiform and metatarsal 
bones, terminating generally in anchylosis of one or more of the 
gliding joints of the hock. 

Why spavin should generally appear on the inner, and but 
rarely on the outer side of the hock^ can be explained by satis- 
factory reasons. 1st. The inner side of the limb is more under 
the central line of gravity: 2d. From the arrangement of the 

cuneiforms, and especially the direc- 
tion of the articular surface of the 
astragalus, the hock is so constructed 
that' when the limb is flexed the 
pressure and conseG[uent concussion 
is thrown on the inner side. Pro- 
fessor Goodsir maintained that a 
screw-like motion of the true hock- 
joint, acting unfavourably on the 
cuneiforms and metatarsals, was the 
cause of spavin. Professor Barlow 
said spavin was due to compression 
of the cuneiforms during extreme 
flexion. Other pathologists maintain 
that concussion, produced when the 
foot comes forcibly to the ground, 
is the sole cause. It is not my in- 
tention to discuss which theory is 
correct. In all probability they are 
all more or less so. 

Bone-spavin is but very rarely 
found on the outer side of the hock. 
Percivall says that he would not be 
sure " that an exostosis upon the out- 
side would be called a spavin, and 
that it is commonly the result of 
injury ;" but I have a specimen in 
my possession, presented by Mr. Stevenson of Newcastle, with 
a spavin in this unusual position, originating from no apparent 
cause, and which produced an incurable lameness"; but I have 
seen several cases from which the lameness entirely disappeared. 
Spavin arises from causes that are hereditary or constitu- 
tional and local. 




Fk}. 50. — Showing situation 
of bone-spavin, a shallow groove 
being left in the ossifio deposit 
for the passage of the oblique 
tendon of the flexor metatarsi, 
immediately under which the 
spavin is situated. 



DISEASES OF THE HOCK. 303 

The hereditary predisposition to bone-spavin is beyond doubt, 
all writers of authority being agreed upon the point, -which is 
also well known to breeders of horses. This hereditary pre- 
disposition is not always due to peculiarity of conformation, 
as many breeds or families of horses with well-formed hocks 
often become unsound from this cause. Peculiarity of confor- 
mation is nevertheless not only hereditary, but is of itself a pre- 
disposing cause of spavin. 

Percivall says — " I am very much disposed to believe in the 
existence in the system of what I would call an ossific diathesis. 
I have most assuredly seen unbroke colts so prone in their 
economy to the production of bone, that, without any assignable 
outward cause — without recognisable injury of any kind — they 
have at a very early age exhibited ring-bones, and splints, and 
spavins. There might have been something peculiar in the 
construction of their limbs to account for this; at the same 
time there appeared a more than ordinary propensity in their 
vascular system to osseous effusion. Growing young horses— 
and particularly such as are what is called " overgrown " 
— ^may be said to be predisposed to spavin, simply from the 
circumstance of the weakness manifest in their hocks, as well as 
other joints. When horses whose frames have outgrown their 
strength, with their long and tender limbs, come to be broke — 
to have weight placed upon their backs at a time when the 
weight of their own bodies is as much as they are able to bear 
— then it is that the joints in an especial degree are likely to 
suffer, and wind-gall and spavin to be the result. Indeed, under 
such circumstances, spavin, like splint and other transformations 
of soft and elastic tissue into bone, may be regarded as nature's 
means of fortification against more serious failures." 

These remarks of Percivall are based upon correct observa- 
tions, and one cannot help admiring the way in which they 
are put before the reader. There is not one point that I can 
dispute, unless, indeed, the term osseous effusion, which may 
not now be looked upon as being consistent with correct patho- 
logical knowledge. 

The local or exciting causes of spavin are sprains of the liga- 
ments, more particularly the inter-osseous, and concussion of the 
bones. The old writers ascribed spavins to blows ; so unlikely, 
however, is the seat of them to receive a blow, that there need 



ft 



304 PAETICXILAK LAMENESSES. 

be no hesitation in declaring such an assertion to have been 
made without foundation. Advantage has nevertheless been 
taken of it, and one often hears sellers of horses declaring most 
solemnly that a very prominent spavin is nothing but the 
result of a kick inflicted before their own eyes, and that it will 
go away in a few days. But a blow sufficiently heavy to cause 
such a swelling leaves a mark ; and, " not to be done," these 
gentry often make a small wound on the skin of the enlarge- 
ment. This is hardly credible, but I speak from actual experi- 
ence and knowledge of facts that have come under my own 
observation. Further, I have heard such men confess that 
such wounds were made for the purpose of accounting for a 
lameness. The young practitioner must not be misled by such 
tricks. 

One fertile source of spavin is the alteration of the direction 
of the leg, brought about by the use of high-calkined shoes. 
These high heels alter the relative position of the limb, from 
the hip downwards, and are a cause of shocks of concussion, 
which are felt every time the horse puts his foot to the ground 
during action. 

The form of Hock most susceptible to Spavin. — Upon this 
point there is much difference of opinion amongst veterinary 
writers ; some maintaining that short-pointed, compact hocks 
are generally spavined ; others think sickle or cow-hocks, and 
hocks " tied in " below ; whilst other writers — more especially 
the advocates of the compression theory — are of opinion that 
hocks with well-developed calces are most prone to become 
spavined. These latter base their argument upon the assump- 
tion that the point of the hock is the lever of the extremity, 
and that the parts in front are liable to compression ; the ex- 
tent of such compression depending on the length of the lever. - 
This theory is self-apparently fallacious, as the lever here men- 
tioned acts in a direction contrary to that which would cause 
compression. 

IsTotwithstanding aU these differences, I do not think that 
there is any kind of hock that can be said to ,be exempt from 
spavii^^rprovided a siifficient cause has been applied. Cavalry 
horses, ^hen the drill and manege exercises were more violent 
than tliey are at present, suffered from spavin to a very great 
extent. " Since, however, the pace has become moderate, and 



DISEASES OF THE HOCK. 



305 



the halts less abrupt, and more time has been given to the 
cavalry recruit horse for the evolution of his natural powers, 
the disease has much abated in prevalence." — (Peecivall.) 

The hock described as " tied in below " is that form where 
the head of the metatarsal and cuneiform bones are small com- 
pared with the bones above. The cuneiform and metatarsal 
bones are receivers of weight and distributors of concussion ; 
their capability to the performance of those functions depends 
upon their size and development, and upon the breadth of sur- 
face they present. When not well developed, one cannot fail 
to see the apphcability of the argument that they are predis- 
posed to spavin, and as a rule practice proves its correctness ; 
but there are many exceptions, and one often sees a badly- 
formed hock remaining sound under very severe tests. 

The theory of Goodsir, that the motion of the true hock- 
joint is like a screw, is well worthy of consideration. I have, 
by the kindness of Professor Turner, obtained the loan of a 
cast of several astragali united together, illustrative of the 
screw-like direction of its articulating surface. The cast was 
prepared by Mr. Stirling, the curator of the Edinburgh Univer- 
sity Anatomical Museum, under Professor Goodsir's immediate 
superintendence. Being the result of the observations of one 
to whom the Edinburgh Veterinary College is so especially 
indebted, it cannot fail to be interesting. 




Pig. 51. — Astragali united to show the screw lines. 



By carefully examining the oblique pulley-like prominences, 
and the deep groove between them, on the superior articulating 

X 



306 PARTICULAK LAMENESSES. 

surface of an astragalus, the observer will see that the screw- 
like motion is subject to three deviations. First, the direction 
is from within outwards for a short distance ; then it seems to 
run perpendicularly ; and, finally, the lines of the prominences 
are seen to curve towards the inner side and on to the inner 
third of the cuneiform magnum, the inner prominence of the 
astragalus terminating abruptly, and leaving a hollow space 
for the end of the internal prominence (malleolus) of the tibia. 
This abrupt termination allows the final act of flexion in the 
hock to be performed with great velocity and suddenness. One 
can see it in a fast-going, well-actioned horse, giving sharpness 
and grace to the hock action ; but whilst it allows this advantage, 
it is apt to be a source of mischief, by acting directly upon the 
cuneiform bones, and proving a source of concussion to them 
during sharp flexion. This, in addition to the concussion 
received when the foot comes to the ground, is sufficient to 
cause inflammation of the cuneiform bones, and spavin. 

The relative obliquity and position of the true hock-joint, 
and the direction of its motion with relation to the production 
of disease of the lower rows of bones, are subjects well worthy 
of consideration, and open a fair field of investigation to the 
veterinary pathologist. Pertinent to this matter, one might 
naturally ask, Why should there be three rudimentary screws 
on the surface of the astragalus? The explanation is based 
upon the fact that the animal must be able to lock the joint 
whilst asleep on its legs. It has been already explained that 
the ligaments and the tendinous structure of the muscles of the 
fore arm enable the fore legs to remain unbent during sleep. 
In addition to tendinous muscles and ligaments, we find that 
the posterior extremities (and they are much more liable to 
bend under the animal's weight, as may be witnessed in cases 
of debility) are furnished with a lock in the true hock-joint, — 
the lock being the deviation of the screw lines, which enables 
it to sleep without falling. The remarkable manner in which 
flexion of the true hock-joint is performed has been remarked 
by Dr. Graves of Dublin; and a valuable paper by Professor 
Dick on the subject, and on the conformation of the knee and 
elbow joints, may be consulted with advantage. It is printed 
along with his memoirs. 

Amongst the variety of hocks that a veterinarj- surgeon 



DISEASES OF THE HOCK. 307 

examines, what is termed a " coarse hock," is often seen. By 
this term is meant a hock with well-developed cuneiform bones, 
giving a prominence to the articulation, very much resembling 
spavin ; and it is generally borne out by experience that such 
hocks are superior to those of a finer description, standing more 
wear and tear, and remaining sound. It was laid down as a 
rule by the late Mr. Barlow, that if both hocks were alike, and 
the action good, joints coarsely formed should not be condemned 
as unsound, more particularly if the enlargements were situated 
towards their posterior aspect. 

I have made many dissections, and found that such enlarge- 
ments were often due to disease, even in horses that were never 
known to be lame. Why the presence of such deposits did 
not cause lameness will be better understood after the pathology 
of spavin has been discussed. 

Many horses are foaled with irregular hocks, very often with 
one hock larger than the other ; and such are apt to be con- 
demned as being diseased and unsound. Experience, however, 
proves that a young horse, rough in his hocks, if put to work 
before he has arrived at his full growth, is apt to fall lame ; 
and that the same animal, if allowed to rest until he is old 
enough for work, will remain sound for many years, although 
a marked disparity may exist between the two hocks. Again, a 
horse at four years old wOl look coarse in the hocks, or even 
spavined ; but when he is six, the same horse will appear quite 
fine and sound, provided he has been properly cared for. 

It is almost impossible to lay down a rule as to what con- 
stitutes an unsoundness, provided the animal goes sound, and 
has pretty good hock action. Spavins in front of the hock are 
generally condemned, and justly so ; but even when so situated, 
one very often finds they cause no lameness, at least during 
the middle period of the animal's life. 

The lameness of bone-spavin is, as a rule, removeable in the 
young and middle-aged, but incurable (with few exceptions) in 
horses past their prime. In the two former it is due to an 
inflammation, which of itself brings about the reparative pro- 
cess • in the latter, to a degenerative disease in the bones, partaking 
of the nature of fragilitus ossium, unaccompanied by a true 
process of repair. 

Patliology. — Bone-spavin consists of inflammation excited in 



308 



PARTICULAR LAMENESSES. 



the cuneiform bones, or in the cuneiforms and large metatarsal, 
and sometimes the inner small metatarsal, either from con- 




FiG. 52. 




Fig. 53. 

Fig. 52 represents the inferior surface of cuneiform medium and 
parvum and os cuboides in a state of ulceration, with their cancelli 
exposed. «, b, Cuneiform medium ; c, Os cuboides ; d, Cuneiform 
parvum. 

Fig. 53. — Articular heads of the three metatarsal bones from same 
hock, a. Large ; h, inner small ; c, puter small, showing caries cor- 
responding to that found in the opposing bones. 



DISEASES OF THE HOCK. 309 

cussion applied to the bones themselves, or extension of inflam- 
mation of the inter-osseous ligaments, which are, in every case 
that I have examined, implicated in the morbid process. 

The inflammation of the bones (ostitis) originates in the 
cancellated structure of their interior; an exudation is gradu- 
ally thrown out between them and their cartilage, pervert- 
ing the nutrition of the latter, whereby it ulcerates and is 
removed, leaving the exposed surfaces of the bones in contact 
with each other, and their cancellated structures in apposition ; 
thus enabling their vessels to communicate with each other, as 
already described in the chapter on Anchylosis. Concomi- 
tant with the destructive process going on in the interior of the 
bones, an exudate is formed upon their periosteal surface, ex- 
tending from one diseased bone to another, binding them 
together by a band of lymph — ultimately converted into bone — 
which locks them firmly together, and prevents further motion. 
In old horses the process of anchylosis is limited to the periosteal 
surfaces, whilst the destructive action stiU. proceeds upon the 
articular ones ; whereas in the young or middle-aged lymph is 
thrown out between the ulcerated surfaces of the bones, which 
is organized into true osseous matter, making the process of 
anchylosis 'complete at all points. The incurability of the 
lameness in the old must be ascribed to this non-termination 
of the process ; for however extensive the deposition of bony 
matter is upon the external surface of the bones, if their exposed 
caneelli come into contact with each other, the lameness will 
most assuredly remain. 

We may now understand why the external deposit is not 
the cause, but the result of the disease, and why its presence 
is not always accompanied by lameness. So long as the 
carious surfaces of the bones are unrepaired, so long wUl the 
lameness remain; but when the bones are locked together — 
are, in fact, converted into one bone, performing the functions of 
one bone — the lameness disappears, and the reparative material 
becomes as one of the essential structures of the economy. The 
destruction of the slight gliding motion of these articulations is 
of but little consequence, as it does not interfere with the flexile 
action of the hock. 

Seasoning upon these observations, and upon the well-known 
fact that an old-standing spavin of the young and middle-aged 



310 



PARTICULAR LAMENESSES. 



horse does not always cause lameness, we are warranted in 
endorsing the popular and common conclusion, that an old- 
standing spavin seldom does harm, and that it 
]>, only during its formation it interferes with 
the usefulness of the animal. 

But a spavin, to terminate so favourably, must 

be limited in its extent ; perfect immunity 

from a recurrrence of lameness may result 

when it is confined to the cuneiforms and 

metatarsals ; but if the superior surface 

of the cuneiform magnum and the lower 

articulating surface of the astragalus are 

involved, in addition to the others, I do 

not think that perfect restoration can be effected. 

In many of the specimens in the College Museum, 

not only are all the gliding bones involved, but 

also the bones of the true hock-joint. Such 

changes must cause permanent lameness. 

In conclusion, I may mention that a practice 
prevails in some parts of the country by which 
hocks that present a want of symmetry in the 
seat of spavin, and particularly if one hock is 
larger than its fellow, are made as nearly alike 
as possible. The operation is called causticking, 
and is as follows: — Upon the coarse hock an 
incision is made a short distance below the 
spavin, and a piece of caustic inserted sub- 
cutaneously to the base of the enlargement. 
This causes inflammation and a filling up of 
the hollow beneath the spavin ; in fact, it hides 
the latter by elevating the former. 

Occult Spavin, as shown in Fig. 53a, is a form 
of hock disease in which inflammation of the 
cuneiform bones and interosseous ligaments, with anchylosis, is 
unaccompanied by any apparent external formation of bone ; the 
spaces between the bones may be filled up with ossific matter 
as in the illustration, but there is no visible enlargement. 




Fig. 53a. 
Occult bone-spavin, 



DISEASES OF THE HOCK. 311 



DISEASES OF THE IJGAMENTOUS AND TENDINOUS STEUCTUEES OF 

THE HOCK. 

Thorough-pin is a bursal enlargement situated on the inferior 
lateral aspect of the thigh and upper and posterior part of the 
hock, arising from disease of the tendon of the flexor pedis pci- 
forans muscle, which is enclosed in a synovial sheath, on the 
inner side of the os calcis, or from dropsy of the sheath, without 
disease of the tendon. The fluid which fills it may, by pressure, 
be forced from one side to the other ; hence the term thorough- 
pin, or running through from side to side. This may be 
described as true thorough-pin, in contradistinction to that 
associated with very large bog-spavins. 

A thorough-pin, however large, does not cause bog-spavin, as 
there is no real channel of communication between the true hock- 
joint and the bursa of the perforans tendon ; but the capsule of 
the joint swells upwards and backwards, bulges into the bursa 
of the tendon, and a large bog-spavin may thus cause the dis- 
tension of the bursa, and the appearance of thorough-pin. 

Thorough-pins are generally found in short, fleshy, upright 
hocks, where the os calcis is short and ill developed. We can 
account for such hocks being subject to them by the knowledge 
that the lever of the limb being a short one, more strain is 
thrown upon the flexor tendons, the flexors of the foot being 
extensors of the hock. 




Fig. 54.— Spring truss for thorough-pm and bog-spavin, designed 
by Mr. Broad, Bath. 

Eailway shunt horses are very liable to fall unsound from 
thorough-pin, in consequence of the very heavy truck loads they 
have to start. 

In the treatment of thorough-pins and bog-spavins, rest, the 



812 PAETICULAPv LAMENESSES. 

liigli-heeled slioe, and pressure by a spring truss, are the most 
elfective appliances. Some recommend puncturing the sac. This 
I have performed in some cases with satisfactory results ; but as 
a rule I think the operation should be avoided. The method of 
puncturing the bursa subcutaneonsly, by making a very small 
incision and drawing out the fluid with a syphon, is useless, the 
sac becoming quite full again in the course of a few hours. If a 
puncture is to be made at all, it should be at the bottom of the 
swelling, sufficiently large to ^ allow the complete removal of 
the fluid; and it should remain open for some days. No fear 
need be entertained, although signs of pain and fever may ensue, 
as an open bursa is not so serious as an open joint. 

After the sac is emptied, a weak solution of sulphate of zinc 
or dilute tincture of iodine may be injected ; the walls of the 
sac brought into apposition by firm but careful bandaging; a 
flannel bandage, owing to its elasticity, being the best of all. 



CAPPED HOOK. 

The gastrocnemius interuus muscle terminates about half-way 
down the tibia in a strong tendon ; it is at first within the tendon 
of the gastrocnemius externus ; winds round its side ; then 
surmounts it, and, on reaching the point of the os calcis, forms a 
cap, giving off slips of insertion from each side to the bone. A 
large synovial bursa exists between the tendons here, and is 
one of the seats of capped hock. 

There are two forms of capped hock — the synovial and the 
serous. 

Synovial Capped Hoch appears as a tense fluctuating swelling, 
situated upon both sides of the point of the hock ; the tendon, 
being posterior to the bursa, prevents the swelling of the internus 
i'rom bulging backwards. It is an unsoundness, causing lame- 
ness, and sometimes the formation of abscesses from caries or 
necrosis of the summit of the os calcis. — (See Photo-lithograph, 
Plate I., Fig. 3.) 

The Serous Capped Hoch, a serous abscess caused by pressure 
or violence, is situated in the areolar tissue, between the tendon 
of the gastrocnemius internus and skin. 

It is not an unsoundness, if not causing lameness, and arises 
generally from the horse strildng the point of his hock against 



ilif. 



CAPPED HOCK. 313 

some hard substance. It very often indicates a kicker, either in 
harness or in the stable, is unsightly when large, and depreciates 
the value of the animal. 

Displacement of Tendon of Gastrocnemius Internus. — Professor 
Dick used to relate that he had met with cases of what he called 
dislocation of the tendon of the gastrocnemius internus, and that 
the tendon had been torn from its attachment to the os calcis. 
He said it always fell to the outside, thereby not untwisting itself 
from the externus ; but that it was quite possible for it to fall to 
the inside. He said that a groove was formed for it on the side 
of the bone, and that the patient regained his soundness. 

This is a rare form of injury. I have recently seen two cases 
of it, arising from kicking, the animals striking the points of the 
calces violently, causing inflammation of the bursse, or synovial 
capped hock. Although in one case the displacement was evi- 
dent very shortly after the infliction of the injury, yet in 
neither instance was there any tearing of the tendons from 
their attachments, but simply an elongation and loss of co- 
hesion, from inflammation in the ligamentous bands which bind 
them to the os calcis, as well as from pressure of the increased 
synovial secretion, allowing the tendons to slip outwards when- 
ever the foot was elevated. 

The treatment consists in throwing the part into a state of 
repose by the application of the high-heeled shoe, cold water to 
the seat of injury, and when the inflammation is reduced, blister 
or firing by pyro-puncture. 

The tendo-achilles may be torn from its attachment to the os 
calcis ; as a rule this is accompanied by fracture or detachment 
of the epiphysis, and occurs in young animals before the ex- 
tremity has become permanently united to the body of the bone. 

INJUPJES TO GASTEOCNEMII MUSCLES. 

Injuries to the gastrocnemii muscles or to their tendons are 
known by the animal presenting symptoms the reverse of those 
manifested when the flexor metatarsi is injured, as in the case 
illustrated at page 297. In injuries to the gastrocnemii, the 
foot is elevated from the ground, as in stringhalt, the leg being 
suddenly brought upward and forward at each step. When 
the animal is standing still there will be knuckling over at the 



'614: PARTICULAE LAMENESSES. 

fetlock-joint, owing to the loss of power in the gastrocnemii, 
which act during repose as extensors of the hock. Division of 
the tendo-achilles is called " ham-strung ; " and when such an 
injury is inflicted, the fetlock is hrought to the ground, and 
the limb is powerless. I have, however, seen such cases do well, 
when the leg has been fastened on to a long stiff splint, extend- 
ing from the foot to the stifle in front of the limb, and kept in 
this position by proper bandages. 



CI7EB. 

This is an injury, sprain, to the calcaneo-cuboid ligament, 
and not to the cellular tissue, as described by Percivall and 
others ; nor is it a sprain of the broad annular ligament which 
passes over and binds down the tendons in their passage down 
the back of the hock, although the annular ligament as well 
as the tendons may suffer when the injury is very violent. Such 
cases are commonly called " sprung hock," and are associated 
with great lameness. 

The original seat of the injury in curb may be at the point of 
attachment of the ligament to the cuboid, or at its ultimate 
termination on the head of the external small metatarsal bone, 
or its attachment to the posterior aspect of the os calcis may be 
lacerated to a considerable extent. 

In the first instance, it presents itself as a small hard nodule 
upon the lower part of the posterior aspect of the hock; so 
small and so hard that it is sometimes impossible to say whether 
it is the injured ligament or the bones themselves. In the 
second, it can easily be recognised as a protuberance upon the 
back of the hock, from four to five inches below the point of 
the OS calcis. 

Curb is apt to cause lameness in young horses, or, when of 
fresh origin, in horses of any age. Curbs of long standing, 
being merely the remains of former disease, very seldom cause 
lameness, and are very often considered by men of experience 
not to be an unsoundness. 

Curby hocks are over-bent or sickle-shaped, and if associ- 
ated with long calces, are almost sure to become the seat of 
true curb. 

Prom what has already been said about the leverage power 



CUEB. 315 

of a long OS calcis, it will- be understood that the ligaments 
which bind it down are much more liable to sprain when 
it is long than when it is short. The form of hock the 
reverse of that liable to thorough-pin is the one predisposed 
to curb. 

An aged horse, when suffering from curb lameness, is gene- 
rally sound again in a few weeks; but if the patient be a 
young horse whose bones are not fully consolidated, it takes a 
much longer time before the parts are restored ; and if such an 
one be put to work before they are thoroughly repaired and 
strengthened, lameness will in all probability recur. Curb 
lameness does not depend upon the magnitude of the enlarge- 
ment, some very large curbs causing little or no lameness, and 
some small ones proving a source of very severe lameness. 
Curb lameness is characterised by difficulty in extending the 
hock, and in some very severe cases by that condition of the 
tendo-achilles already described, the limb being elevated, and 
the tendo-achilles remaining in a state of relaxation. This arises 
from the animal avoiding to exercise muscular force on the os 
calcis, and endeavouring to mitigate pain. 

Horses liable to curb should be shod with a shoe high in 
the heel, and care should be taken that it be not allowed to 
wear too low, else lameness is almost sure to recur. Cart-horses 
with curbs should not be shod with high toe-pieces, or the 
increased resistance to the action of the muscles upon the calcis 
Avill cause lameness. 

Whether a curb be an unsoundness or not must be left 
to the practitioner;- legally it is so, but in reality an old 
curb, unaccompanied by heat of the part, and causing no 
lameness, does not generally interfere with the usefulness of 
the animal. 

In some parts of the country young animals are fired to 
strengthen the hocks, and prevent curb and spavin. Such cases, 
when they come before the veterinary surgeon for examination 
as to soundness, have a suspicious look about them, but if the 
hocks are good and the action sound, the marks of the cautery 
are no indication of unsoundness. 

This practice of firing to prevent disease is most cruel and 
useless. It cannot be too strongly condemned; and Martin's 
Act should be applied to every one guilty of such barbarity. 



316 PAKTICULAE LAMENESSES. 

Trcaiinent of Curl. — Eest, a high-heeled shoe, reduction of 
the inflammation, and afterwards removal of the thickening 
by means of iodine or its salts. If lameness is persistent, 
firing. 

The tendon of the flexor pedis perforans is liable to injury 
as it passes through the tarsal groove, succeeded by great lame- 
ness, distension of the bursa, the swelling prominent both below 
and above the hock on its postero-internal aspect. The tendon 
is bound down at the tarsal groove by the posterior annular 
ligament, thus preventing the swelling from appearing except 
above and below. 

The superior tarsal ligaments correspond to the radials ; 
the metatarsals to the metacarpals in the fore extremity. Both 
are liable to sprain, the latter much oftener than the former, 
characterised by lameness, swelliog, and other signs already 
described. 



CHAPTER XVII. 

TREATMENT OF LAMENESS. 

REST POSITION OF THE LIMB REMOVAL OF SHOES IIIGn-IIEELED 

SHOE THIN-HEELED SHOE HOT AND COLD FOMENTATIONS 

LOCAL BLEEDING — PDRGATIVES — COUNTER-IRRITANTS — BLIS- 
TERS SETONS ACTUAL CAUTERY THEORY OF THEIR ACTION. 

Befoee describing the diseases of the feet, which are so 
numerous and important as to require special consideration, I 
will endeavour to give a brief description of the treatment of 
lameness. The first and most important necessity in this matter 
is to form a correct diagnosis ; without this all is hap-hazard, 
and calculated to do much harm. The next step is the removal 
of the cause, if that be possible, and of every circumstance cal- 
culated to aggravate the effect. After these things are attended 
to, the position of the limb and foot demand attention, in order 
that the patient's efforts to remove pressure and tension from 
the seat of pain may be assisted. If a lame horse stands with 
the foot of the lame limb flat upon the ground, that is to say, 
touches the ground with both heel and toe, and if the feet are 
strong and good, I am of opinion that all his shoes should be 
removed, in order that he may stand upon his feet, and be 
able to poise his body in nature's way. But if his feet are bad 
and weak, they must be protected by light plain shoes. Trifling 
cases of lameness, where in all probability recovery will take 
place in a few days, are exceptions to this method ; but in all 
instances where it is likely the patient will require a period of 
rest, the plan is to be highly commended. 

If, however, the horse is inclined to elevate the heel, to stand 
on his toe — the posture indicating that parts are thus relieved 
and pain diminished — he must be encouraged in this by having 
a patten or high-heeled shoe applied. This will, in many in- 



318 TREATMENT OF LAMENESS. 

stances, afford mucli immediate relief; but if, on the contrary, 
he is inclined to throw his weight upon the heels, a thin-heeled 
shoe should be used. The shoe recommended by Mr. Broad, of 
Bath, for laminitis, which will be described hereafter, answers 
the purpose in all such cases, except when the posterior part of 
the limb and heel descend from ruptured sesamoidean ligament, 
as already mentioned. 

Such, then, are the first circumstances to which the practi- 
tioner must attend, in order to place the injured structures in 
a state of repose. 

When the parts are put in as complete a state of rest 
as possible, the effects of the primary lesion will command 
attention. These are inflammation, with pain, and perhaps 
swelling. 

The inflammation is the result of the injury, and, except in 
cases where the textures involved have become torn, lacerated, 
or crushed, it is the only morbid condition present in the early 
period of the lameness. 

It is of the utmost importance to bear this in mind, as by 
proper attention to the animal, alterations of structure may be 
prevented ; whereas if he be now neglected, worked from day to 
day, and otherwise improperly treated, organic changes ensue, 
rendering the lameness incurable, or curable only by a length- 
ened process of repair. 

For the reduction of the inflammation, hot or cold applications 
to the part are useful. I prefer warm, considering that they are 
more soothing in the early stages than cold. Notwithstanding 
my own preference to warm applications in the earlier stages, I 
must in justice state that the general belief is in the efficacy of 
cold at first, warm afterwards ; and that this belief is based upon 
the ground that cold moderates excessive vascular action, by 
causing vital contraction of the vessels, and hence its applica- 
tion immediately after the receipt of blows or injuries restrains 
inflammation ; and that heat acts by soothing the nervous system 
of the part, relaxes the vessels and tissues, so that the vessels 
relieve themselves by effusion ; in other words, heat promotes 
the secretory inflammation. 

There is, however, no rule to guide the practitioner in pre- 
scribing either hot or cold, and the choice is very often a matter 
of experience. 



COUNTER-IEEITANTS. 319 

In all painful affections, -warm fomentations or poultices must, 
as a rule, be prescribed ; in the course of some days, however, if 
the pain is subsiding, and the parts seemingly relaxed, much 
benefit will be obtained by making a change to cold, mild astrin- 
gents, and bandages, to promote absorption of the exudate. 

The congested capillaries mny be relieved by local bleeding, 
but the parts upon which such an operation is performed are 
very few, except about the coronet or the foot. An incision 
into the coronary plexus wiU reach the vessels at once ; the 
utility of this is, however, very doubtful, except in rare cases. 
Bleeding at the toe, although much practised by some, is not to 
be commended. 

Purgatives are very useful during the first stages of lame- 
ness, reducing the inflammation ; a full dose of aloes may be 
given with advantage, the diet being properly regulated, and 
restricted to bran-mashes, a little hay, and the water to be 
chilled. 

After the acute signs of inflammation have subsided, if the 
lameness still remains, the application of the so-called counter- 
irritants will be rendered necessary. 

These consist of rubefacients, blisters, setons, and the actual 
cautery. The action of these remedies differs only in degree, 
in rapidity, and in permanence, not in the nature of the exuda- 
tion which they produce. 

The theory of counter-irritation is one of gi-eat obscurity. It 
is all very well to say that counter-irritants act by causing 
metastasis, or a translation of the disease from one part to an- 
other. I need scarcely here discuss the origin of the idea that 
it is based upon the assumption that no two inflammations can 
exist in the system at the same time, and that by exciting a 
manageable superficial inflammation we counteract or remove 
the deep-seated and unmanageable one. This theory of counter- 
irritation is founded upon a false and irrational basis, and has 
been the means of destroying the lives of thousands of horses. 
Without entering into any speculative discussion upon the 
question, superficial irritants are very beneficial in all cases of 
chronic lameness, whether it be caused by disease in bone, car- 
tilage, ligament, tendon, or any other structure ; and they are 
often more decidedly beneficial when applied to the diseased 
structure itself than to the skin covering it. Por example, a 



320 TREATMENT OF LAMENESS. 

lameness arises from bone-spavin ; its eradication is much more 
certain and rapid when a pointed cautery is applied to the 
diseased bones than when the hock is fired in the ordinary way. 
Again, a spavin has been fired and bUstered repeatedly without 
benefit ; the bones are " punched " — a barbarous operation, and 
only to be performed in extreme cases — violent inflammation 
is excited in the diseased bones, which for a time increases the 
lameness ; but this gradually subsides, and the original lameness 
is found to be removed. 

How, then, are we to account for such results ? Certainly 
not by the theory of metastasis. Dr. Bennett, sceptical as he 
is in most things, seems to believe in the doctrine of counter- 
irritation, and thus expresses himself : — " Artificial irritations of 
the skin, to produce internal or distant effects, are caused by 
what are denominated counter-irritants, including stimulants, 
frictions, hot applications to parts, sinapisms, blisters, moxas, 
cauteries, &c., &c. These all operate through the nerves by 
reflex action ; some, like warm fomentations, soothe irritation ; 
others, as blisters, create it locally, but remove it where it was 
primarily seated. How this is accomplished constitutes one of 
the most vexed questions in therapeutics." — (Bennett's Prin- 
ciples and Practice of Medicine?) 

I am of opinion that the curative action of external irritants 
is not due to their producing metastasis or counter-irritation, but 
that they excite within the originally diseased structure a repara- 
tive inflammation, partaking in its nature of what is described 
by Yirchow as the " secretory inflammation," which, superseding 
the original diseased process (whether that be inflammation pure 
and simple or its effects, ulceration, caries, or the formation of 
a low form of fibrous tissue), excites the formation of reparative 
material, by which breaches are united, ulcers healed, and 
diseased action removed. 

To illustrate this view, I will bring forward two familiar ex- 
amples : — Is;;. The healing of a sinus or fistula, after the applica- 
tion of a blister, or of the actual cautery to the skin contiguous 
to it; and 2d. The removal of phlebitis by a blister. 

In the first instance, we find that a sinus heals after a blister 
or cautery by the formation of an organizable exudate, which 
completely fills up the cavity of the sinus ; and, in the second, 
we find that a blister assists in the obliteration of the inflamed 



COUNTEK-IKEITANTS. 321 

vein ; not by removing the inflammation from it, but by pro- 
moting the formation of a large quantity of reparative lymph, 
and hastening its further development into fibrous tissue, by 
which the vessel is transformed at the inflamed part into a 
fibrous cord. Now, if the curative action were due to the re- 
moval of inflammation, we should find that in the first case the 
relief would be only of a temporary nature ; the sinus would still 
remain, being generally the cause, and not the effect, of the 
morbid action ; and in the second, that the inflammation being 
removed from the coats of the vein, the vessel would, upon re- 
moval of the clot, become pervious. But such is not the case. 
Let the clot be removed ever so often, it is sure to form again, 
and nothing has the power of overcoming the inflammation of 
the vessel until it has been transformed into an organized cord 
— a process most materially hastened by the application of a 
blister. 

I think it may therefore be accepted that external irritants — 
whether they be simply rubefacients, producing a mere redness 
of the skin, vesicants or blisters, which cause elevations of the 
cuticle by fluid underneath it, or cauterization and setons, which 
promote the suppurative action — remove lameness by assisting 
nature in a process of repair. 

Rubefacients may be employed in the less severe forms of 
lameness, in sprains of tendons, or in slight affection of joints, 
along with rest and fomentations, after the more acute symp- 
toms have passed away. 

Misters. — It is usual to apply blisters in all cases of some 
standing, when organic changes in the parts involved are sus- 
pected. Before a blister is applied, the hair should be clipped 
from the part, which, if dirty, ought to be washed, and when 
dry, the blister to be applied with smart friction for about ten 
minutes. To obtain the full effect of a blister, a quantity of 
ointment is to be thickly laid on after the rubbing-in is com- 
pleted. 

The best agent is cantharides, in the form of acetate, tincture, 
or ointment ; to the limbs, the ointment in preference ; one part 
of cantharides to twelve parts of lard or palm oil. If prepared 
with a temperature equal to the boiling-point of water (212°), 
it will be sufficiently strong, and will never blemish. It is 
a mistake to think that the powdered flies should be mixed 

y 



322 TKEATMENT OF LAMENESS. 

■with the vehicle when it is nearly cold : an ointment so pre- 
pared wUl require three times the quantity of cantharides, 
The heat melts the cantharidine. 

Hints upon Uistering gen&rally. — N'o more than two legs are 
to be blistered at one time, and three weeks at least must be 
allowed to elapse before the others are blistered, and between 
each re-apphcation. It is bad practice to blister extensively in 
very hot weather ; and it is a mistake to suppose that blisters 
to the loins and' back are more apt to irritate the urinary organs 
than when applied to any other part of the body, provided that 
it be carefully and properly done. 

The evil results of blistering are — 

1st. The production of strangury, by the absorbed cantharidine 
irritating the urinary passes. This is a very rare occurrence, 
provided the blister has been applied to a moderate extent of 
surface; but if four legs, or even two, be very extensively 
blistered at one time, the occurrence of such may be laid down 
to the indiscretion of the practitioner. In some cases, however, 
very moderate blistering is followed by strangury, and when it 
does occur, it is best treated thus : — Pirst wash the blistered 
surface with warm water, in which a little alkali has been dis- 
solved ; dress it with oil ; give the animal demulcents to drink, 
such as cold linseed tea ; and admi|iister a few doses of opium 
and bicarbonate of soda. 

2d. The production of a considerable amount of nervous 
irritability, fidgetiness, quickened pulse, and injected mucous 
membranes, with loss of appetite. These symptoms are due 
to a nervous temperament ; and if not very severe, had better 
not be interfered with. Should they become alarming, the 
animal must be treated as in the first instance ; the fomenta- 
tions being continued for a longer period to the legs. It may 
b^.fhere mentioned that fomentations should not be hot, but 
fehingiy warm. 

Sometimes blisters, no matter how carefully applied, 
^ce excessive swellings of the limb or limbs, with a ten- 
id^lcy to suppuration and sloughing of the skin. These re- 
sults are generally due to the animal being in bad health, 
and in a condition tending to anasarca or to erysipelatous 
disease. The treatment must consist of purgatives or diuretics, 
as the case may be, fomentations, astringent lotions, and gentle 




BLISTERING. 323 

exercise, as soon as the pain is sufficiently subsided to admit 
of the animal heing moved about. In many cases the swellings 
involve the sheath of the penis and the under surface of the 
abdomen. Punctures are very useful in such parts, by allow- 
ing the escape of the contained fluid. I have seen tetanus 
arise from a very limited blister to one fore leg. 

It is necessary to tie the horse's head to the rack after a 
blister has been applied, in order that he may not bite it, 
or lick it with his lips or" tongue, and thus blister the mouth 
and blemish the blistered spot. It is also necessary to tie the 
head so that the horse cannot lie down, for if he lies upon the 
blistered limb the vesicant wiH adhere to that part of the body 
brought in contact with it whilst the animal is recumbent, and 
produce an effect upon it as well as upon the part to which it 
has been purposely applied. If the bhstered spot be within 
reach of the tail, the tail should be tied up, or it is apt to 
become daubed, and the blister whipped on to the thighs, sheath, 
or mammary gland. 

If the effects are not sufficiently apparent in about thirty 
hours after the blister has been applied, a very little more, or 
what is remaining on the skin, which may be sufficient, should 
be gently rubbed in ; and in about forty-eight hours after the 
application the part is to be washed, and every trace of the 
blister removed ; a little oil being now applied, or, what suits 
perhaps better, an emulsion of sweet oil, carbonate of potash, 
and water. It is a mistake to keep the parts soft too long ; 
the eschars should be allowed to accumulate, and to desc[uamate 
gradually. ' 

When the head is untied from the rack, a cradle must be 
put on the animal's neck to prevent him from biting the blisterlp 
spot. A cradle is, however, useless when the lower part^of 
the fore legs is blistered, since the animal can elevate his f^gt 
from the ground, and thus get at them with his teeth; aifd 
when he is lying the cradles are of very little use when a bli^er 
is below the knee. In such cases the best method is to Ap 
the head tied up until a thick scab is formed, which will de^y 
itchiness in the part. 

Firing, or the application of the actual cautery, is supposed 
by some to be beneficial in acting as a suppurant, and by others 
in forming a permanent bandage round the part; but I appre- 



324 rSEATMENT OF LAMENESS. 

hend there is not mucli truth in either of these suppositions. It 
is a much more severe irritant than a blister, and often removes 
pain very rapidly when repeated blisters have failed to do so. 
In bone diseases, and in all causes of chronic lameness, it is of 
great benefit, and seems to act by powerfully exciting the heal- 
ing process in the part diseased. 

The firing may be in lines, and superficial, the transverse 
method being the least calculated to blemish ; or it may be in 
points, and deep, by pyro-puncture (see drawing of instrument, 
Fig. 24, page 159), and into the diseased structure. This 
latter method is the more easily performed, and the more 
effective. 

^Nothing is more calculated to dispel the idea of the correct- 
ness of the coMwto'-irritation theory than the dissection of a 
part which has been recently fired (say three days after the 
operation), when it will be found that the skin, subcutaneous 
tissue, and the bones — when they are superficially situated, such 
as those of the hock, pastern, &c. — are involved in the inflam- 
matory action so induced. Thus a bone-spavin lameness is 
removed by the inflammation excited by the cautery in the 
diseased bones, providing a supply of material for the purpose 
of imiting them together into one immoveable mass ; or, as in 
caries of a ginglymoid joint, for the repair of destroyed structure, 
as already explained. 

Setons act very satisfactorily in some cases of bone diseases, 
especially in those accompanied by external heat of the part ; 
they produce a discharge of pus, and their action can be con- 
tiojied for a much longer time than that of blistering or firinor. 
In tendinous or ligamentous lamenesses, with much thickening 
of the integuments and subcutaneous structures, setons should 
not be employed, as they leave much additional thickening, and 
are not so effectual as the actual cautery. 



326 DISEASES OF THE FEET. 

an analysis of their writings shows that the work of one is 
often a mere repetition of that of another. Nearly all have run 
in the same groove, promulgating false ideas from one genera- 
tion to another, to the incalculable deterioration of the useful- 
ness of the horse. Indeed, such is the prejudice, and so deeply 
rooted are men's opinions, that it is dangerous for any one 
to teach a more rational doctrine. If such an one is now 
and then bold enough to point out the errors of the past, he 
stands a fair chance of being considered a dreamer, or something 
worse. 

Nearly aU writers upon the subject have looked upon the foot 
as a very wonderful and complex piece of mechanism, and seem- 
ingly have forgotten, or have not known, that no matter how 
complex it may be within, it is enclosed in a simple horny 
box ; that aU the efforts of shoeing should be directed to pre- 
serve that box in a natural condition ; and that its position in 
relation to the limb should not be altered by the shape or form 
of the shoe. 

Many have maintained, and some still maintain, that the 
horny foot is an elastic, expanding, and contracting organ, 
and that its elasticity should be kept intact by paring the sole, 
peculiar nailing on of the shoe, and by keeping the foot as moist 
as possible, by stuffing, spongio-piline, &c. Others, again, sup- 
pose that a mechanical advantage can be given to its tendons 
and ligaments by the form of the shoe ; in fact, by improving 
upon nature. 

AH these are errors, and have originated with men who 
have built their conclusions upon mere hypotheses. It is not 
my intention here to enter minutely into the question of 
horse-shoeing, but merely to state, in the first place, that it is 
essential to abolish the drawing-knife ; and in the second, that 
calkins and toe-pieces should be done away with for all kinds 
of horses except those used for heavy draught in towns where 
the streets are paved and steep. All horses required to go 
beyond a walking pace are injured by shoes with turned-up 
heels and toes. Farm-horses, and those employed upon 
macadamised roads, are better without than with heel and 
toe-pieces, although the pace they are required to go is never 
faster than the walk ; in fact, where possible, all horses should 
be shod with a flat shoe. 



EEMAEKS ON SHOEING. 



327 



The form of the shoe which I recommend is represented in 
the following woodcuts ; ' and it ought to be so made and fitted as 




Fig. 55. Pre. 56. 

Fig. 65. — Inferior (concave) surface of shoe. 
Fig. 56. — Superior (flat) surface of shoe, bearing on the sole, 

to bear upon all parts of the sole and crust that are calculated to 
bear pressure. Experience and anatomical im'estigation point 
to the conclusion that the sole 
as well as the crust is intended 
to perform this weight-bearing 
function : the sole around the 
margin of the crust for the dis- 
tance of about half-an-inch in 
all parts of the foot except at 
the heels — i.e., that part of it 
embraced in the triangle be- 
tween the wall and bar ; in fact, 
the seat of corn. Here the shoe 
should rest upon the wall only, 
being made sufficiently narrow 
at this part (as seen in Figs. 55, 

^' ■' "" o T n ^ '^^^ ^""^ prepared for the shoe. The 

a shoe, all parts of the foot cal- sole, frog, and bars untouched with the 

culated to bear weight are caUed ^ff f<"^ ^7° y^' i ^'^^f t*°f ^- ^^^f^ 

o . of toe and depth of wall kept m their 

upon to perform their natural relative positions by the rasp only. 

function ; the various structures 

kept in their proper and relative position ; the frog allowed to 

come to the ground to prevent concussion; the weight of the 




328 DISEASES op THE FEET. 

animiil's body diffused over an extended surface, and not limited 
to the wall alone, as in the common method of shoeing with a 
seated shoe ; slipping prevented, by the rim of the concave shoe 
and the wedge-shaped frog grasping the ground. 

This method of shoeing has been practised at the forge of the 
College with the most beneficial results for several years, and 
even in such a city as Edinburgh, where the streets are so steep 
and slippery, with the great advantage that horses slip less than 
when shod with turned-up heels. I feel quite conrlnced that, if 
such a shoe were generally adopted, lameness in the feet would 
be much more rarely met with ; but such is the prejudice, even 
amongst those who have the opportunity of seeing the beneficial 
results of the system, that it is almost impossible to convince 
them that it is an improvement. One large cab projprietor says 
— " All my lame horses go better in your narrow-heeled shoes, 
especially my ' groggy horses ;' " but even he will not have his 
sound horses so shod. 

As to the desirability of pressure upon the sole, my views are 
borne out by many practical men, especially by Mr. Broad of 
Bath, a gentleman who has studied the subject very deeply. His 
essay upon horse-shoeing, which gained the second prize of £30, 
given under the auspices of the Scottish Society for the Preven- 
tion of Cruelty to Animals, is replete with instructive matter, 
and ought by all means to be published. 

It must, however, be borne in mind that the sole, to bear its due 
proportion of weight, should be left unmutilated by the knife. 

To return to the subject of lameness. The diseases of the feet 
may be arranged as follows : — 

1st. Diseases of the bones and cartilages. 

2d. Those originating in the horn-secreting structures ; and, 

3d Accidental injuries. 



I. — LAMENESS FKOM DISEASE OF THE PYRAMIDAL PROCESS OF THE 

OS PEDIS. 

This form may exist either in a fore or a hind foot, and results 
from blows upon the front of the coronet, or from over-extension 
of the extensor tendon (attached to the point of the pyramid) by 
the use of high calldns. 



DISEASE OF THE OS PEDIS. 329 

^ Symptoms. — Swelling on the front of the coronet, varying in 
size from that of a hazel nut to that of a pigeon's egg, with 
lameness, which is often very persistent. The peculiarity of 
gait is manifested by the horse putting the heel down first, and 
often taking the foot up very quickly as soon as the toe comes 
in contact with the ground. There will be pain on pressure, 
and some heat ; now iuid tJien the skin ever the enlargement 
sloughs, leaving a woimd, which heals with difficulty; or a 
wound may be present from the first, if the injury has been due 
to external violence. 

Treatment. — Low-heeled bar shoe; fomentations, poultices, 
and rest ; succeeded by blisters, or the application of the actual 
cautery. In some cases the lameness resists the most active 
treatment, and upon examination after death, caries is found to 
have destroyed the pyramid of the bone, and extended into the 
pedal articulation. Neurotomy, if there be a good foot, might 
be tried in cases that resist aU other treatment. 



n. — OSSIFICATION OF THE LATEEAL CAETILAGES. 

Side-Bones. — Commonly met with in heavy horses, and in 
the fore feet. I have seen the lateral cartilages of the hind ones 
ossified ; but this is very rare, and, so far as I know, never occa- 
sions lameness. 

The lateral cartilages are two thin plates of fibro-cartilage, of 
an irregularly quadrangular form, surrounding the wings of the 
OS pedis, which, in virtue of their elasticity, assist the sensitive 
frog and soft structures of the foot in regaining their natural 
position after being pressed upwards and outwards by the weight 
of the animal. An opiaion prevails that these fibro-cartilagin- 
ous bodies assist in the expansion of the foot. Undoubtedly 
they expand at their posterior border each time the animal puts 
his foot to the ground ; but in this expansion of the heel they 
are mere passive agents, being, in fact, pressed outwards by the 
structures contained in the space between them. They are, 
however, active agents in causing the contraction of the heel; 
for when the pressure is removed from their inner surfaces, they 
then tend to assume their natural position in virtue of their 
elasticity; and the pressure they exercise upon the sensitive 
frog forces the heel into its original shape. Briefly, they may 



330 



DISEASES OF THE FEET. 



be said to be forced to expand -when the foot is on the ground, 
and that they actively assist contraction when the weight, which 
forces the sensitive frog upwards and outwards, is removed from 
the foot. 

It must not be understood that I am advocating the theory 
that the foot expands upon its inferior surface ; that supposition 
is now entirely disregarded ; but no one can deny, what is ap- 
parent to the most ordinary observer, that the foot expands at 
the coronet and heels ; not the horny foot, but the soft parts of 
the heels and coronet. To prevent undue expansion of these, 
the lateral cartilages are placed as elastic sides. 

Ossification of the Lateral Cartilages. — As already stated, side- 




FlG. 58 shows osaifination of the lateral cartilages, with 
fracture of the altered structure upon one side, at its junc- 
tion with the pedal bone. 

bones are commonly met with in heavy draught horses ; indeed, 
a great majority of this class is found so affected by the time the 
animal is six or seven years old ; and this seems to arise from, 
the over-expansion of the cartilages caused by the great weight 
of the animal. The process of ossification is very often a slow 
one, unaccompanied by any acute inflammatory action, giving 
the animal no pain, and causing no lameness. 

The causes of ossification of these cartilages are — hereditary 
tendency, and shoeing with high calkins. It is generally ad- 
mitted that the predisposition to side-bones is hereditary, and 



OSSIFICATION OF THE LATERAL CAETILAGES. 331 

many breeders of the best class of cart-horses, being aware of 
the fact, are careful not to breed from an animal with them. 

High-heeled shoes prove a cause :— 1st. Because the shock 
received by the heels when the foot comes to the ground is 
transmitted directly to the cartilages ; 2d. Because the pres- 
sure upon the heels of the wall is unnatural and excessive, the 
frog being prevented from bearing its proper proportion ; and, 
od. Because they are pulled inwards and downwards by the 
sensitive frog being pressed downwards, whilst it horny covering, 
being removed from the ground, forms no column of support. 

Side-bones are a cause of unsoundness, but all horses so 
affected should not be condemned on this account, and it may 
be laid down as a general rule, that if the feet are strong, open, 
and well developed, the horse showing no lameness should 
not be condemned for side-bones. But if he is stilty in his 
action, even without actual lameness, or if the feet be con- 
tracted, altered in form, weak in the heels, flat or convex iu the 
sole, there should be no hesitation in pronouncing him unsound. 

Occasionally the lighter-bred horse is found to have side- 
bones, which are usually attended with lameness ; whether lame 
or not, such an animal is unsound, since he is unfit to perform 
his ordinary labour, as trotting upon the roads is sure to set up 
the inflammatory process in the cartilage, and cause lameness. 

To detect these deposits, it is necessary to press upon the 
cartilages ; naturally, these are yielding and elastic, but when 
ossified they lose this character, becoming hard, unyielding, 
and enlarged. The deposition of bone may be uniform, in- 
volving the whole substance of the fibro-cartilage, or it may 
be in isolated spots, either at the junction of the cartilage with 
the pedal bone anteriorly, or involving the posterior borders, 
forming a hard kernel-like enlargement. 

The anterior side-bone more commonly causes lameness than 
the posterior one. 

Side-bones differ from ring-bones, both in the structures they 
involve and the lameness they occasion. Side-bone lameness 
is characterised by the toe of the foot being first brought to the 
ground ; when both feet are involved, by a shortness of step 
and want of elasticity or springiness in action, resembling that 
of navicular disease. 

Treatment. — Bar shoe ; rest, blisters, firing ; and should these 



332 DISEASES OF THE FEET. 

fail, neurotomy. The Frencli operation of removing the deposits 
by excision has not found much favour in this country, nor do 
I think it likely that it will do so, as the incurability of the 
lameness is generally due to other structures besides the lateral 
cartilages being involved in the diseased process. An examina- 
tion of Fig. 5 in Photo-lithograph, Plate III., will illustrate 
this, and throw a light upon the circumstance that side-bones 
are occasionally the cause of incurable lameness. 

Neurotomy is very successful in removing this form of lame- 
ness, and is attended with more permanently beneficial results 
than when performed for navicular disease. 

It will be useful to bear in mind that when these cartilages 
are ossified, the horse's gait wiR lose that elasticity which is 
so essential to good action. In the cart-horse this is not of 
much consequence, but in the horse required for other paces 
than the walk, it is of the greatest importance, not only as a 
question of soundness or unsoundness, but of the usefulness of 
the horse and safety of the rider or driver. 

III. — NAVICULAE DISEASE. 

This is the most fertile cause of lameness that we know of 
in the better-bred horse — the bane of horse-flesh. At one time 
all cases of obscure lameness in the fore extremity were attri- 
buted to the shoulder ; but after the discovery of James Turner, 
all were said to arise from navicular-joint disease. 

Should the student desire the history of this disease, he will 
find it treated very fully by Percivall in his book on Lame- 
ness (1849). It was called navicular arthritis (Percivall), and 
podotrocliolitis (Beauel) ; and has been ascribed to various con- 
ditions, such as contraction of the foot (Coleman) ; laceration 
of the fibres of the perforans tendon, as it passes under the 
navicular bone (Dick) ; inflammation of the synovial membrane 
(Turner, Percivall, and others) ; inflammation of the synovial 
membrane only, or of that and the navicular bone (Buauel) ; 
and inflammation, having its origin in the interior of the navi- 
cular bone, leading to exostoses on or caries of the inferior 
articulating surface, with degeneration of the fibres of the tendon 
(Broad of Bath), and its causes to a variety of circumstances, 
as best suited the whim and fancy of the theorist; such as 



NAVICULAR DISEASE. 333 

non-paring of the foot, destroying its elasticity (Coleman) ; a 
shoe thick at the toe, causing increased resistance to the action 
of the flexors, and rendering the perforans tendon liable to 
strain (Dick) ; thin-heeled shoes, by throwing the weight and 
concussion on the posterior parts of the foot and frog, bruising 
the synovial membrane; hereditary tendency; bad shoeing; 
bad nailing ; want of exercise ; too much exercise, &c. 

I. Contraction of the Foot. — Messrs. Turner and PercivaU 
wrote, that "of contraction there may be two kinds. 1st. A 
contraction of the heels, called lateral contraction; 2d. Con- 
traction of the hoof from below upwards, or vertical contraction;" 
and these were said by Professor Coleman to be the cause of 
this lameness. He maintained that " expansion of the hoof 
is effected by pressure upwards of the frog, and pressure down- 
wards of the navicular bone. By properly thinning of the 
sole, rasping the quarters, lowering the heels, giving the frog 
pressure, and keeping the horse in a pond all day, or else tied 
up with his lame feet in a tub of water, we have no difficulty 
in removing contracted hoofs. Although difficulty there be 
none, however, in restoring the original form of the hoof, 
we too frequently find we have gained nothing by it, because 
we have not restored the original structures of the parts con- 
tained within the hoof Contraction of the hoof in consequence 
of the internal parts being squeezed produces inflammation of 
the laminae, and ossification of them. This causes the horse, 
in galloping, to avoid to his utmost coming down upon his 
heels, or to tread upon hard ground ; the concussion at such 
times being great from loss of elasticity in the lamina, so that 
the moment he comes to work he falls lame. In nine eases 
out of ten of what are termed ' groggy ' or ' foundered ' 
horses, these parts, in consequence of chronic inflammation, 
become altered in structure ; effusion of lymph or bony matter 
taking place." I have thought it expedient to make this 
extract from Coleman, in order to show the kind of pathology 
taught by him ; and I hope to be able to point out the mischief 
brou"ht about by it — conclusions and generalities without one 
fact to support them. 

Contraction of the hoof is not a cause, but an effect, of 
disease ; an atrophy of the structures contained within the horny 
box consequent upon diminished functional activity and adapta- 



334 DISEASES OF THE FEET. 

bility of the hoof to the atrophied structures, which it encloses 
and protects. Professor Dick said there was a kind of con- 
traction of the hoof, in fact a natural tendency to tliis in the 
domesticated animal, arising from a want of moisture when he 
is confined in the stable. This kind of contraction, he main- 
tained, did not cause lameness, " as the soft parts became 
adapted to the alteration of the hoof." Now, in my opinion, 
this kind of contraction would be the one most likely to cause 
lameness ; indeed, it would be impossible for an animal not to 
be so, if the pressure of the drying hoof were sufficient to cause 
atrophy and absorption of the sensitive tissues within. That 
horses' feet do become contracted, more especially at the heels, 
without lameness, I do not deny. I do not think, however, 
that this is due to any want of moisture, but to the removal 
of the horn from the heels and sole during the operation of 
shoeing, for the parts contracted are those situated posterior 
to the wings of the os pedis, where the space between the two 
quarters and heels of the hoof is filled by the elastic sensitive 
frog, a structure possessing but little sensibility. The great 
barriers to the eoUapse of the hoof at this part are strong 
heels, bars, and sole ; but if the smith, by the so-called " open- 
ing of the heels," remove such a quantity of horn as to weaken 
the foot, can we wonder that it collapses, and that its sides 
approximate each other too closely ? 

Sometimes one foot may be found contracted through its 
whole extent without lameness. This may be due to some 
natural peculiarity in the animal, just as we find that a man 
may have one foot smaller than its fellow ; or it may arise 
from the circumstance of the animal having been lame in that 
foot or that limb while young. I have often found a small 
foot to be due to a previous lameness in any part of the limb 
or the foot, and to accidental circumstances. The explanation 
is easy. When an animal is lame in any part of the limb, he 
avoids putting weight on the foot of that limb; the conse- 
quence is loss of function and wasting, and in the young 
animal, a cessation of growth ; whilst the opposite foot, having 
to bear more than its proper share of weight, becomes enlarged 
in aU directions ; in fact, grows rapidly; in order that it may 
be able to maintain the extra amount of weight thrown upon 
it. The disparity between the feet wiU remain through life. 



NAVICULAH DISEASE. 335 

and the animal may be sound. Again, both fore feet are 
sometimes appai'ently contracted without lameness, but if 
examined closely, they will be found to be small and not con- 
tracted ; the bones of the limbs will participate in the peculi- 
arity of conformation ; they wiU be narrow from side to side, 
and in all probability the hind feet will be smaU also. The 
contraction of the feet due to navicular disease will be found 
in the foot or feet that are lame, and it is an atrophied con- 
dition, resulting from diminished function, disappearing by 
degrees if the original disease, or the pain resulting therefrom, 
can be eradicated ; for example, if the original freedom of action 
is restored to the parts by neurotomy, the disease still being 
present, the foot or feet contracted wiU regain their original 
dimensions. 

II. S^prain or Laceration of the Fibres of the Perforans 
Tendon. — This was the theory taught by Professor Dick, and 
accepted by myself and the great majority of his pupils. He 
said — " I have endeavoured to demonstrate that primary and 
permanent disease is established in the synovial capsule, between 
the tendon and navicular bone, and arises from strain and over- 
extension of the tendon, where it passes under the navicular bone. 
It has predisposing causes, such as want of paring, shoeing, and, 
still more, bad shoeing ; hereditary tendency of particular breeds, 
and high condition, for it is a disease rarely of the agriciiltural, 
but of the high-bred horse. In like manner, it has manifest 
exciting causes, such as strain of the tendon and over-exertion, 
pressure on the sole, as from travelling with a stone in the foot ; 
and there is the tight shoe, exciting irritation of the foot, 
which, hot and uneasy in the stable, is aggravated by occa- 
sional and violent exercise." Towards the end of Professor 
Dick's career, the idea that the disease was due to laceration of 
the tendon became more firmly held by him, and that this was 
caused by bad shoeing, that is to say, by allowing the toe of the 
foot to be too long, and applying a shoe, thick and irregular at 
the toe, which, by increasing the resistance of the foot, when 
implanted upon the ground, to the action of the flexor muscles, 
threw an additional strain on the tendon where it passes under 
the navicular bone. 

During the last five years I have made numerous post moo-tem 
examinations of navicular disease, and am convinced tliat strain 



336 DISEASES OF THE FEET. 

or laceration of the tendon is never a primary condition, and 
that the disease commences as an inflammation of the cancel- 
lated structure of the navicular bone, or of the cartilage upon its 
inferior surface. It was very hard for me to believe that a 
theory which had so much to support it, and which I had advo- 
cated ever since my student days, could be erroneotis. I am 
sure that all the students of my predecessor will remember how 
enthusiastic he was while lecturing upon this subject, and how 
he showed us specimen after specimen where the tendon was 
lacerated and adherent to the bone. In order to establish the 
correctness of this view, it was necessary to have provided a 
specimen with the tendon diseased or lacerated, and the surface 
of the bone in its natural, or at least in a slightly altered condi- 
tion ; but this could not be done, and it was taken for granted 
that the altered structure of the bone arose from the primary 
lesion being in the tendon. 

As a mere speculation, the view that the primary condition 
arose from laceration of the tendon could do no harm ; but as a 
pathological fact, influencing men's minds upon the question of 
the non-removal or even non-prevention of this lameness, it has 
done infinite harm ; for it involved the supposition that navicular 
joint lameness was almost incurable, and as such it is now looked 
upon by the majority of the profession and the public. Even 
when most enthusiastic in my views as to the correctness of Pro- 
fessor Dick's theory, I was often startled by seeing many cases 
of navicular disease, when attended to in the early stages, recover 
after a short period of rest. 

Pathological examinations were made by Professor Dick to 
an extent surpassed by none ; but he contented himself with 
investigating the condition of the outside of the bone and tendon, 
and if nothing was apparent there, the lameness was ascribed to 
sdme other cause. 

If navicular disease were due to sprain and laceration of the 
tendon, how is it that it so very rarely affects the hind feet ? ^ Is 
it because the flexors of the hind extremities are more favourably 

^ I have in my possession one specimen, sent me by Mr. Clark, V.S., Coupar- 
Angus, of acute inflammation, with incipient ulceration, of the navicular bone 
of a hind foot ; but even in this case, although the symptoms of lameness were very 
great and intractable, and were supposed by one veterinary surgeon to be due to 
fracture of the pelvic bones, there is no appearance whatever of laceration of the 
fibres of the tendon. 



NAVICULAK DISEASE. 



337 



placed than those of the fore limbs ? I think the most devoted 
advocate of the theory will scarcely venture to answer in the 
affirmative; but should he feel inclined to think so, let him watch 
a horse in motion with a load behind him, and he will very soon 
see that the flexors of the hind limbs are called more powerfully 
into action than those of the fore ones ; for in addition to acting 
as flexors of the feet and pasterns, they are extensors of the 
hocks. If strain were the cause, navicular disease, owing to 
the double function the flexor perforans is called upon to perform, 
and the more powerful strain thrown upon it in the removal 
of heavy loads, would be found in the hind, and not in the fore 
feet. 




Fig. 59 represents the phalangeal bones in their naturally oblique 
position, and it will be seen that from the upper part of the 
long pastern (a) bone, down to the toe of the os pedis (c) is a con- 
tinuous oblique line. This obliquity of position enables the bone to 
act as a spring, for the purpose of modifying concussion. Every 
horseman knows that the more oblique the pastern, the greater the 
elasticity of step and freedom from jar ; that the pace is easy for the 
horse, and delightful to the rider. The coronary bone (6) rests en- 
tirely upon the os pedis, and the navicular bone (d) placed posteriorly 
bears no weight, but gives increased leverage power to the tendon ( e). 
It is a muscular appendage, like the sesamoids, and is not intended 
to be a weight-supporting bone. 

Navicular disease is due to the rheumatoid diathesis and to 
concussion, and the liability to suffer from the first-named 
cause originates in hereditary predisposition and accidental 
circumstances ; and to the second in conformation (as narrow 
feet with short upright pasterns), and in the unnatural altera- 
tion of the relative position of the navicular and weight-bearing , 

z 



338 



DISEASES OF THE FEET. 



bones, brouglit about by the application of shoes wbich are 
cither turned down, calkined, or made thicker at the heels 
than at the toes. 




Fis. 60 represents the bones when their position is altered by a 
thick-heeled shoe ; the line is changed from its natural obliquity to a 
direction approaching the perpendicular. The lower end of the os 
coronae (6) is made to rest upon the navicular (d), as well as upon the 
pedal bone (c). The navicular bone is made to bear weight for which 
it was not intended, neither is its structure calculated to do so. All 
weight-bearing bones have their fibres arranged to receive weight 
upon their extremities, but the fibres of the navicular, and of all the 
sesamoidean bones or muscular appendages, are not so arranged, and 
weight thrown upon them induces disease. 

The development of navicular lameness from rheumatoid 
disease is occasionally due to what Professor Dick termed 
" occasional exercise," which implies long periods of rest, inac- 
tivity, and irregular work. Professor Dick maintained that 
during rest there was a deficiency of synovial secretion, and 
that when an animal, with his joints and bursse in this dry 
condition, was suddenly put to fast work, the effects of the 
friction upon the surface of tendon, moving under the bone, 
were laceration of its fibres and navicular disease. Whether 



NAVICULAE DISEASE. 339 

this dryness of the bursje be present or not, it is very true that 
want of exercise is a powerful predisposing cause of the disease, 
and, doubtless, its effects are due to the localisation of a consti- 
tutional tendency to rheumatoid bursitis— (See Eheumatoid 
Aethritis.) The other accidental causes are pressure of a stone 
m the foot, impacted immediately below the bursa, and exciting 
inflammation; punctures, and allowing the toe of the foot to 
attain an inordinate length. The most frequent predisposing 
cause being the abnormally relative position of the phalangeal 
bones, either arising from congenital formation of limb, or 
induced by shoeing with thick-heeled shoes ; the exciting cause 
must be looked for in the pace. Eace-horses, so long as they 
are shod with racing shoes, rarely suffer from navicular disease. 
The pace with them tells upon the column of weight-bearing 
bones and upon the ligaments and tendons, but when put to 
liarness-work, in carts, omnibuses, &c., and shod with thick shoes, 
they soon become unsound. 

Hunters, again, are not nearly so prone to become lame from 
navicular disease as harness-horses ; but if strain were the cause, 
they would be continually falling lame. They are, however, 
shod with a level shoe, which allows tlie frog to touch the 
ground, and the great concussive shocks, which would be other- 
wise inflicted at every jump the animal is called upon to take, 
are thus modified or destroyed. 

At one time I was of opiuion that compression was the cause ; 
that the tendon caused so much pressure upon the bone as to 
produce irritation, and gave the animal a feeling of uneasiness 
in the first instance, as evidenced by "pointing of the foot" 
before lameness was apparent. I am, however, forced to abandon 
this supposition, and to come to tlie conclusion that " pointing " 
indicates a condition of ostitis sufficient to excite a feeling in 
the horse that something is wrong, which is insufiicient to cause 
actual lameness. 

Symptoms. — The lameness is manifested in two ways: — 1st. 
Suddenly, and perhaps without apparent cause, veiy often im- 
mediately after the horse is newly shod. It is then attributed 
to some fault in the nailing ; but on examination, nothing wrong 
is found in the nailing, or that the shoe has bruised the foot in 
any part by undue pressure. After a time this lameness may 
disappear, or it may disappear from one foot, and after an in- 



340 DISEASES OF THE FEET. 

definite period reappear either in the same foot or its fellow. 
The rheumatoid form is thus manifested. 2d. By a slow and 
insidious process in one or both feet, and this is the most 
common form ; the first noticeable sign being pointing of the 
foot, succeeded after a time by "shortness of the step" and 
lameness, which may be of a transitory character. For example, 
" a horse may quit the stable apparently sound, and it very often 
happens that the rider or driver may fancy that the horse now 
and then goes lame. The foot is examined, and nothing found, 
and next morning he may seem all right again. The next 
I'ourney perhaps, or rapid work, brings back the lameness, which 
after a little rest and a poultice to the foot disappears again ; he 
may perhaps favour it a little, but there is nothing of conse- 
quence the matter, but in the end, if the fast work is continued, 
the case becomes confirmed." — (Percivall.) 

The diagnostic signs of navicular lameness are — 1st. Negative ; 
2cl. Positive. (1.) The negative signs are the absence of injury 
to any part of the limb, and of any apparent disease. These are 
diagnostic of foot lameness, and are of importance, as they limit 
the seat of the disease to the foot. This region must now be 
explored, and lameness in the foot may exist from various 
causes, but in each variety the signs are diiferent. If laminitis 
be present, there will be heat, tenderness, &c. If a corn be the 
cause, its presence is easily detected; in fact, in nearly every 
other form, except navicular arthritis, there will be some appre- 
ciable sign ; but in the disease in question — if we except occa- 
sional heat and tenderness in the hollow of the heel, or redness 
of the frog and sole immediately below the navicular bursa — 
there will be no apparent sign. The redness of the frog and 
sole, now and then met with, is very characteristic when really 
due to navicular disease; but it is not always to be depended 
upon, as it may arise from external injury, such as treading 
upon a stone, and may be superficial only. Pointing of the foot 
or feet, although a most valuable adjunct to a correct conclusion 
when taken along with other signs, is of itself quite insufiicient 
to mark the seat of the lameness ; for it may depend upon other 
causes, such as splint, sprain, ring-bone, &c. ; or an animal may 
voint and be perfectly free from any unsoundness. This " point- 
ing" may be a mere habit, or a sign of fatigue. In such 
instances, however, it differs in its character from the pointin<' 



NAVICULAR DISEASE. 341 

of lameness. When a mere habit, or arising from fatigue, the 
animal stands with one fore foot and then the other in a semi- 
flexed position, in a careless lounging fashion ; but he points two 
limbs simultaneously ; that is to say, one /ore and the Mrid limb 
of the opposite side of his body. But in pointing from disease, 
one foot only is pointed at a time ; and when one limb or foot 
is diseased, that foot only ; when both fore feet, each foot alter- 
nately. 

(2.) The positive signs. If, along with absence of other disease 
in the foot or limb, there be the heat and tenderness upon pres- 
sure at the hollow of the heel, or the redness of the sole already 
spoken of, these may be looked upon as positive signs. Many 
veterinarians, by exercising great pressure upon the heel and 
violently flexing the pastern, cause the horse to show signs of 
pain, which they consider sufficient to denote navicular lame- 
ness ; but the severe way in which some make this examination 
is sufficient of itself to cause the pain, and even to aggTavate 
any other disease in the limb. I have for a long time ceased to 
have faith in this method of manipulation, and for the reason 
that many horses will wince upon pressure, no matter where 
the lameness may exist, and content myself with tlie action of 
the horse, which may be looked upon as furnishing the most 
positive sign. 

A horse suffering from this lameness comes out of the 
stable after an interval of quietude stiff and lame ; he may be 
scarcely able to put his lame foot to the ground, but after he 
has been exercised for a short time, particularly if the ground 
be soft, the great lameness disappears. If he be lame in both 
feet, his step is short and stilty, and he seems rigid and 
bound by some stiffness of the muscles of the chest and 
shoulders. On this account our forefathers called the disease 
"chest-founder." There is nothing, however, wrong with the 
shoulders or chest, and the peculiar rigidity of movement and 
shortness of step are thus explained: — 1st. The shortness, be- 
cause the pain felt in the foot implanted on the ground causes 
the animal to relieve it as soon as possible by bringing down 
the other foot, just as a man lame in both feet is compelled to 
take short steps whilst walking. 2d. The stiffness arises from 
an aversion to aU movement on the part of the sufferer, because 
flexion of the foot excites pain in the bursa. He also naturally 



342 DISEASES OF THE FEET. 

avoids elevating it to any extent, from an instinctive know- 
ledge that the concussive shock would be materially increased 
when (after such elevation) it is again brought to the ground. 
In addition to shortness of step and rigidity of movement, the 
wear of the shoes is characteristic. They are worn at the toes ; 
the patient avoids bringing his heels down, and he digs his toes 
into the ground. Wlien the animal is lame in one foot only, this 
peculiar appearance of the shoe is of great assistance to correct 
diagnosis. 

Professor Dick says that "the symptoms of the early, and, 
in a practical point of view, the most important stage of the 
disease, are a peculiar shifting of the feet, and a shortness of 
the step; while a degree of heat is found in the foot, more 
especially about the heel and coronet. There is a continual 
pointing or holding of the foot in a relaxed position, dryness 
of the hoof, throbbing of the plantar arteries (?) and pain on 
pressure in the hollow of the pastern. The other parts of the 
limbs are clean and fine ; there is general tenderness of the foot 
on pressure, with tripping and stumbling ; and finally, the foot is 
contracted." 

Contraction of the foot always succeeds navicular disease, and 
in some instances the atrophy is not confined to the foot, but 
extends to the muscles of the shoulders and fore arm. This 
wasting has, however, no further connection with the disease 
than that it results from diminished function, due to limited 
action, as already explained. 

Pathology.— DxQ parts involved are the navicvdar bone, the 
articular cartilage, the synovial membrane of the bursa, and 
the tendon of the flexor pedis perforans. The inflammation 
is first limited to the cancelli of the bone, or the cartilage, as 
illustrated by the following plates. 

The tendon passes under the bone, as a rope under a pulley, 
their surfaces being in a more complete co-adaptation from the 
circumstance of the bone having a process or eminence across 
its middle, to which the tendon is fitted by a corresponding 
hollow in its substance. As a rule, it is the crest of the 
bone that shows the earliest signs of caries; whilst calcifica- 
tion of the cartilage is usually seen upon either side. Inflam- 
mation having been set up in the vascular cancellated structure 
of the bone, the progress of that inflammation may lead to a 



NAVICULAR DISEASE. 



343 



variety of changes, both within its interior and upon its articular 
surface ; in one instance, to the deposition of small calcareous 




Tig. 61 represents longitudinal sections of four navicular bones, sawn 
through their middle as near as possible. 

1. Healthy bone. Cancelli in their natural condition, with distinct 
spaces (areola) between the bony trabeculae. 

2. Early stage of ostitis. The bone presents almost an ivory-like 
appearance, from exudation (and ossification of the exudate) into the 
areolar spaces, rendering the bone almost solid. 

3. Second stage. Showing rarefaction of the bony tissue, and expan- 
sion of the areolae ; the inflammatory new formation has been absorbed ; 
the cancelli are enlarged, and cavities are formed (indicated by the dark 
spots) by absorption of the bony trabeculse. The exterior of this bone 
shows no signs of disease. 

4. In this figure both the processes, viz., consolidation and rarefaction, 
are going on. In the centre and to the left hand, dark spots (foraminaB) 
are seen, indicating the destructive (raref active) process ; whilst to the right, 
and indeed almost surrounding the cavities, the bone presents the ivory-like 
appearance, the natural areola being filled with bony matter. 2 and i 
represent changes that are consonant with those of rheumatoid disease. 

spots upon and within the cartilage (see No. 2, Kg. 62) ; 



344 



DISEASES OF THE FEET. 



in another, to the formation of large carious-looking cavities ; 
exposing the vascular interior of the bone (see No. 3, Fig. 62), 



k < 






Fra, 62 represents external appearance of inferior articulating surfaces 
of four navicular bones. 

1. Apparently healthy bone ; externally it presents no appearance of 
disease. It is carefully selected as typical of an apparently sound bone, its 
cartilage of incrustation being intact, and the tendon perfectly healthy. 
The animal from which it was taken had been lame from navicular disease 
before its death. Its internal appearance is represented by No. 3 in the 
preceding illustration. 

2. Calcification of the articular cartilage. The calcareous spots indi- 
cated by the dark dots ; interior of this bone much opened up. 

3. Caries of articular surface. 

4. Adhesion of tendon to the exposed cancelli of the bone. 

■with gradual removal of the bone, its texture at same time 
becoming friable, until at last it may become fractured by some 



NAVICULAR DISEASE. 345 

trivial accident. In otlier instances the destructive process is 
limited (see No. 4, Fig. 61, page 343) ly ossification of the 
cancellated spaces limiting the boundaries of the cavities by 
a more or less solid osseous wall. Not only are the natural 
areolae of the interior structures solidified, but the vascular canals 
within the trabecnlse are blocked np by osseous material, the more 
effectually to arrest the process of destruction ; and for the same 
purpose, and to limit motion as much as possible, the tendon be- 
comes adherent to the bone. This adhesion of the tendon occurs 
in two ways: — 1st. Its fibres are lacerated and present loose ends. 
These are imprisoned by lymph thrown out from the exposed 
interior of the bone, and are united to it by a new connecting 
fibrous tissue. 2d. By the formation of a false membrane, 
which is very vascular, similar to that already described 
(Goodsir's false membrane), extending from the synovial fringes, 
both on the inferior surface of the bone, and superior surface 
of the tendon, creeping by slow degrees over the whole articu- 
lar surfaces, destroying their smoothness, and becoming a bond 
of union between them. In some specimens all semblance 
to a bursa has been destroyed by the parts becoming completely 
united together, and secretion of synovia, being no longer 
required, has entirely ceased. In the earlier stages the synovial 
secretiou seems to be augmented, and this was considered by 
Professor Dick to give rise to the fulness which is sometimes 
observable in the hollow of the heel. In some rare instances 
the navicular and pedal bones become anchylosed by spiculse of 
bone from the inferior border and extremities of the navicular, 
and from the posterior part of the pedal bone. 

The changes in the tendon are indicated by, first, softening 
and fibrniisation of its superior surface j the splitting up is not 
altogether due to friction against the roughened surface of the 
diseased bone, but to degeneration of the structure of the ten- 
don, from the inflammatory action having extended to it from 
the bone, and increased vascularity of its connecting tissue. 
This splitting up or rupture of the fibres is manifested by the 
surface of the tendon being covered by tufts of loose, stringy, 
whitish fibres, with their free extremities floating in the secre- 
tion of the synovial membrane, until an exudate is formed, by 
which they are at a later stage united to the bone. 

The synovial membrane, at a very early stage, is involved in 



346 



DISEASES OF THE FEET. 



the inflammatory action ; its vessels are injected, its surface 
presenting a red streaky appearance; it becomes slightly, but 





Flo. 63 shows the gradual ejection of the tissues of the cartilage at the ulcerated 
spots. In the centre of the hollow the superficial parts of the cartilage have disap- 
peared, and the deeper parts are undergoing degeneration, becoming irregular, 
shrivelled, losing their walls, and discharging their contents. — (After Kedfern.) 

Tig. Si. — Vertical section of cartilage, showing the notches produced by burst- 
ing of the cells, and the fibrous and granular mass on the free surface. — (Ebdpern.) 

This figure very fairly illustrates the change in the navicular cartilage at an 
eaxly stage of its conversion into a finely granular calcareous substance. 

never much thickened; in very 
chronic cases its free surface 
becomes involved in the gene- 
ral adhesive process, and united 
to the tendon and bone. 

The changes in the cartilage 
are the same as when the carti- 
lage of incrustation is inflamed 
in an articulation (see Chapter 
XI.) ; it is either removed from 
thesurface of the bonebyulcera- 
tion, or converted into iibrous 
tissue or a calcareous material. 

The supposition that the sur- 
FiG. 65 shows the superficial cells of face of this Cartilage is naturally 

the cartilage enlarged, and passing into a , , , . , 

granular and fibrous mass on the surface. Covered by a membrane IS not 

borne out by microscopic inves- 
tigation; the supposed membrane being nathing more than 
the cartilage corpuscles, which are flattened upon the free sur- 




NAVICULAR DISEASE. 347 

face of all articular cartilages. — (See Pig. 36.) It is true that 
the navicvilar bone, like the sesamoids and the bicipital groove 
of the humerus, is covered by a cartilage with fibrous tissue im- 
bedded in its matrix, but there is no membrane on the surface. 

The phenomena observable during the course of the disease 
here call for remark, more especially the variation in the point- 
ing of the feet. One animal will exhibit this sign before any 
lameness is manifested, whilst another will have been lame for 
some time before it begins to point. In the first instance, the 
pain in the part is due to a very slight degree of inflammatory 
action, and marks a slow, insidious development of the disease ; 
there is sufficient pain to cause uneasiness whilst the animal is at 
rest, and when his attention is not called away from it ; but when 
at work, the excitement of exercise, more especially if he be a 
high-spirited horse, makes him forget his pain, or the pain itself 
is dissipated by movement. In the other case, sufficient injury 
has been inflicted to cause immediate lameness, and this may 
last for some time before the animal becomes habituated 
to the method by which some degree of relief is secured by 
pointing. The act of pointing is performed in two ways : — 1st. 
By extension of the limb and of the pastern, the heel of the foot 
resting upon the ground, the leg stretched forward before its 
feUow. In this form relief is obtained by the increased obliquity 
of the pastern, and by an endeavour to approximate the column 
of bones to their natural position, whereby weight is taken off 
the naAdcular bone. The other method is by flexing the limb, 
touching the ground with the toe only, the heel elevated, 
the flexor aspect of the limb relaxed, and the inflamed part 
relieved of tension and pressure as much as possible. This 
form is indicative of more advanced disease than the former, of 
denudation of the osseous cancelli, and fibrilHsation of tlie tendon. 

The concavity of the sole of the foot is gradually increased, 
and the frog hardened and elevated from the ground, or soft- 
ened by a discharge from its cleft and surface. These changes 
are, however, but a part of the general atrophy of the foot ; there 
is decreased functional activity; the heel is not brought firmly 
to the ground, and its structure wastes or becomes diseased. 

In discussing the causes of the disease, I have stated my 
opinion that generally the alteration in the direction of the 
bony column by the shoe, or by a natural upright conformation 



348 DISEASES OF THE FEET. 

of pastern, is the great cause. In addition to this violent 
interference with the designs of nature, the elevation of the 
heels furnishes additional cause of concussion to those already 
stated, by removing the frog from the ground ; the frog being 
elastic, tough, and strong, intended to touch the ground and 
diffuse concussion, as well as to prevent slipping at each step 
the animal takes. When left in its natural condition, it is a 
large tough, softish body, giving way to the pressure of the 
fingers when manipulated, expanding each time the foot is piit 
to the ground, the commissures at its sides admitting of this 
expansion without the other parts of the foot being interfered 
with. So long as it touches the ground, the sensitive parts 
within, and particularly the navicular bursa for which it 
furnishes, a soft bed, rests upon a resUient body, free from 
concussive danger. Besides furnishing this soft bed, it per- 
forms another important function ; being elastic within and 
without, it assists the flexors in the first act of elevating the 
foot from the ground, and it does this in virtue of its inherent 
power of assuming its original shape when the superincumbent 
weight is taken away from it. Thus, whilst on the ground, 
and bearing its proportion of weight, it is flattened from side 
to side, bulging into the commissures and cleft, ready at every 
movement, like a piece of india-rubber, to assume its proper 
form when the least portion of the weight is taken from it. 
When the flexors are acting, it becomes narrowed from side 
to side, and deeper from surface to surface, and during this 
assumption of its natural form, it gives an upward impetus to 
the foot, which is of essential importance to its easy elevation. 
The removal of this frog pressure during long periods of rest in 
the stable is also a fertile source of the disease, because the frog 
becomes hardened, and does not furnish a soft cushion for the 
bursa to rest upon. The question may be very properly asked, 
Why, if concussion be the cause of the disease, the caries does 
not appear upon both synovial surfaces of the navicular bone ? 
The answer to this may be found in the following remarks, 
namely — 1st. That the lower surface and tendon were intended 
to rest upon the soft resilient frog, and not upon a hardened 
body, like what we find in improperly shod horses. 2d. That 
the changes of tissue consequent upon functional activity is 
greater upon the surface under which the tendon plays. 3d. 



NAVICULAE DISEASE. 349 

Ulcers have always a tendency to open upon parts nearest the 
surface of the hodyj and, finally, because this surface, being 
deprived of its soft cushion (the frog), receives a greater amount 
of concussion. 

Treatment. — EecoUecting that the first stage is that of in- 
flammation, all means should be used to arrest this process 
before any alterations of structure have taken place. Shoes 
are to be removed; the frogs allowed to touch the ground; 
blood is to be withdrawn from the toe, or coronary plexus ; and 
the feet placed in a cold water bath for several hours during 
the day, and in a poultice at night. Whilst in the bath the 
horse's head must be tied up; but when he is out of it he 
should be encouraged to lie down, for the purpose of taking 
weight off the feet. This method of treatment, with an occasional 
purgative and a cooling diet, has proved most successful. At 
the end of a fortnight, whether the lameness be removed or not, 
a mild blister round the coronet is very useful; but should 
this plan prove of no avail, a seton must be inserted through 
the frog. If the near foot is to be operated upon, the needle 
should be introduced from the frog upwards ; but if the off 
one, from the heel downwards, if the operator be not left- 
handed. It is seldom necessary to cast the animal. The horny 
frog must be well pared, and if the needle — a sharp-pointed, 
short, curved one — be passed quickly, the operation is generally 
completed before the animal knows much about it. It is 
necessary that care should be taken not to introduce the needle 
too deeply, as the tendon may be wounded ; the point of the 
needle should be introduced into the frog about one inch from 
its toe, and brought out midway between the bulbs of the 
frog and the anterior boundary of the hollow of the heel. 
The ends of the tape must be tied together, so as to form a 
loop, which is to be sufficiently long to admit of a little move- 
ment in dressing, but not so long as to extend to the boundary 
of the wall, or the horse, by treading upon it, will soon destroy 
it. Before the seton is introduced, it is usual to put on the 
shoe, for the purpose of removing weight from the irritated 
frog. About three weeks or a month is the usual time for 
keeping the seton in the frog, dressing it daily, and keeping 
the foot clean. After its removal, the frog must be examined, 
for usually it is "under-run" between the two orifices,jjby 



350 DISEASES OF THE FEET. 

purulent matter ; if sucli be the case, the detached horn must 
be removed, and the exposed parts dressed with a little tar. If 
structural changes have not taken place, this plan of treatment 
will usually be found effective ; but if the lameness continue 
after a month has elapsed after the removal of the seton, all 
treatment will be useless, and the animal should be put to slow 
work, or the pain removed by neurotomy. 

This operation (neurotomy) is a very simple one, if care be 
taken. The incisions ought always to be made in the hollows 
immediately above the sides of the fetlock-joint, in order that 
the inner cicatrix be protected from injury from the opposite 
foot. Two methods of procedure were recommended by Pro- 
fessor Sewell and others, namely, to perform above the fetlock, 
called the " high operation," or below it, called the " low 
operation." The high operation includes the division of the 
trunks of the plantar nerves ; and the low, the division of their 
posterior branches only. Had success attended the latter 
method, it would have been the more satisfactory plan; but 
unfortunate]y it does not entirely remove the lameness. 

To operate successfully, the following rules must be followed : 
— \st. Clip the hair finely over the course of the nerve, that 
is, immediately anterior to the anterior border of the perforans 
tendon. 2d. Let the animal be made to stand in cold water 
for an hour before operating; this lessens the tendency to 
hsemoiThage from the small vessels necessarily cut through. 
Zd. Oast the animal carefully. The leg to be operated upon 
must be removed from the hobble, but fastened to the hind 
leg by the side-line extended from above the knee to the thigh ; 
the foot pulled forward by a cord or strap tied round it, and 
held by an assistant. It is necessary to extend the fetlock- 
joint, or the incision might be accidentally carried into the 
sesamoid bursa. 4<A. Feel for the edge of the tendon, and cut 
boldly but carefully down upon the nerve, exposing it without 
dissecting the areolar tissue, bth. Divide the nerve as high 
up as the incision will admit, in order that the skin may over- 
lap its exposed extremity, and dissect out at least an inch of 
its length. The nerve is always divided at the superior part 
of the wound, in order that the infliction of pain be not 
repeated, as would be, the case if the first division were made 
below. &th. When the nerve is removed, the lips of the wound 



NAVICULAR DISEASE. 351 

may be brouglit together by suture, pin, or plaster, the latter 
being preferable, as leaving less blemish. It is usual, when 
both legs are to be operated upon, to perform the operation on 
the one lying undermost, of course dividing the inner nerve, 
and upon the outer side of the upper leg, before turning the 
animal. When the operation is completed, the patient is 
allowed to rise, removed to the stable, and there tied, so that 
he cannot lie down or interfere with the wounds for three or 
four days. If pins or sutures have been inserted, a covering 
of styptic colloid or collodion may be applied after the slight 
haemorrhage has ceased ; after this is done, if the parts are not 
interfered with, it will be found that they will unite by the 
adhesive process. 

Unfavourable results of the Operation. — These are many, even 
in weU-selected cases. If the selections are not judicious, the 
operation is calculated to do much harm, and to bring discredit 
upon the practitioner. 

In determining whether it is judicious to operate or not, 
the following rules must be borne in mind : — Is^. Never 
operate on a very heavy, thick-legged cart-horse : 2d. Wever 
operate where the feet are thin, weak in the heels, full in the 
sole, or otherwise exhibiting a predisposition to laminitis ; and 3d 
Operate only where the foot is good and strong, the animal's 
action not too high, and the lameness otherwise incurable. 

The untoward results are fracture of the navicular bone, 
rupture of the tendon, sloughing of the hoof, and a peculiar 
gelatinous degeneration of the bursa, tendon, and surrounding 
structures, along with the formation of a large q^uantity of a low 
form of fibrous tissue. 

The first symptom of this degenerative process is a bulging, 
doughy, or elastic swelling in the hollow of the heel ; the ani- 
mal at the same time going upon the heel more than usual, 
and the toe slightly elevated at every step it takes. This 
peculiarity of gait may at first be so slight as almost to escape 
notice; but it is a symptom of importance, and should be 
carefully noted, since it indicates that the tendon and the 
other structures are losing their cohesion, becoming soft, and 
more or less extensible. The external swelling increases, 
until it surrounds the whole of the coronet, and extends up- 
wards to the fetlock-joint. The divided extremities of the 



352 



DISEASES OF THE FEET. 



nerves frequently becoming 




Tig. 66. — Off fore leg after neuro- 
tomy, showing external appearance 
of gelatinous degeneration of its 
structures, with rupture of the flexor 
tendon and inferior navicular liga- 
ment, and fracture of navicular bone. 



at the same time very sensitive 
to the touch, from a deposition 
between their fibres; lameness 
may arise from this cause, or it 
may be absent. As the swelling 
increases, the coronet and pastern 
present a tense glistening appear- 
ance, and the elevation of the toe 
becomes greater by degrees, or 
suddenly, from rupture of the ten- 
don; the leg assumes a form 
similar to the annexed figure. 

The condition illustrated by the 
woodcut (Fig. 66) is similar to 
what surgeons denominate gela- 
tinous degeneration, or strumous 
disease of the joints ; and for the 
purpose of comparison, I give a 
description of the examination of 
the leg from which the woodcut was 
drawn, and the pathological condi- 
tion of a joint subject to a similar 
disease in the human subject. 



(l.) PATHOLOGICAL APPEARANCES OF THE KAVICULAE-JOINT AND 
SURROUNDING STRUCTURES OF THE FOOT REPRESENTED IN 
FIG. 66. 

External Appearances. — In the space usually denominated the 
pit of the heel, but which now, owing to the altered position of 
the foot, constituted its posterior part, there was a prominent 
bulging or elastic doughy swelling. On removing the skin, exten- 
sive deposits of a gelatinous or fibrinous material were revealed 
surrounding the pastern and fetlock joints, involving the extensor 
and flexor tendons, forming a soft cushion for the lacerated struc- 
tures to rest upon, and embracing in its interstices a large quan- 
tity of a sero-sanguineous fluid. 

The flexor perforans had been ruptured at that portion which 
jjasses under the navicular bone ; but the rupture was not com- 
plete, the inferior layer of fibres remaining still unbroken. The 



NAVICULAE DISEASE. 353 

divided ends of the tendon were some distance apart, and they 
bore a jagged appearance, owing to the formation of fringe-like 
processes of a gelatinous material, containing some blood-vessels, 
which gave to the new formation an appearance similar to that 
of pale muscular tissue. The inner or anterior surface of the 
tendon bore evident traces of ulceration and gelatinisation ; and 
it had an appearance of ecchymosis in its structure. 

The inferior broad navicular ligament was ruptured, its divided 
edges presenting the same appearances as those of the tendon, 
but were considerably more vascular. 

Appearances of the Navicular Bone. — Externally, its postero- 
inferior surface presented no distinct traces of ulceration ; the 
cartilage was absorbed ; and the bone presented a vascular dirty- 
brown appearance, and its articular cartilage was covered over by 
a vascular membrane, the processes of which could be distinctly 
seen penetrating the structure of the bone, and extending over 
more than one-third of the bursal surface. The bone was frac- 
tured at about half an inch from its right extremity. 

(ll.) PATHOLOGICAL ANATOMY OF GELATINOUS DEGENERATION, OR 
STRUMOUS DISEASE OF THE JOINTS, IN THE HUMAN BEING. 

" Gelatinous degeneration may attack any joint in the body, 
but those most frequently affected are the knee, elbow, and 
ankle. I shall take the knee-joint as an illustration, as the 
disease, especially that of the low chronic form, is most fre- 
quently there situated. 

" In about six weeks after the commencement of the disease, 
a partial swelling is found on either side of the patella, extend- 
ing towards the posterior aspect of the lateral ligaments. This 
increases around the patella, and the markings of the bone are 
gradually lost in it. The swelling presents either a peculiar 
elastic or a doughy feel. As the disease goes on, the symptoms 
become more marked, the colourless swelling increases, the joint 
becomes more tense, and has a glazed appearance. 

" The pathological condition leading to these symptoms con- 
sists in a peculiar degeneration of the synovial membrane. 
This exists under two forms, and these have been described 
under two separate names — the gelatinous and pulpy degenera- 
tion: but they are truly identical in symptoms, and as regaras 

2 a 



S54: DISEASES OF THE FEET. 

the essential nature and course of the disease. In the gelatinous 
degeneration, all the cartilages of incrustation become gradually 
covered over by masses of new deposition, which extend wher- 
ever there is a synovial membrane. In the recent state, this 
deposit has a gluey or jelly-like character varying in colour 
from pale yellow to dark brown, and is generally intersected by 
lines of white membraneous structure. This is the more general 
character of gelatinous disease ; but there is another condition, 
in which the membrane assumes a sort of granular or fungoid 
appearance on the surface. This has been described as pulpy 
degeneration; but all the phenomena are the same as in the 
former case, and there is no use in making a distinction between 
the two conditions. The deposit fills up the whole joint, and 
acts as a kind of soft cushion, protecting the ends of the bones, 
so that at first, when the swelling is most marked, there is com- 
paratively little pain. 

" The cartilage of incrustation is removed by absorption ; the 
absorption is induced by the pressure of the new material on its 
surface, or by a peculiar action which the deposited substance 
exerts upon the cartilage. All the textures are ultimately in- 
volved ; not only the synovial membrane and the cartUage, but 
also the fibrous textures and the areolar tissue. This gives rise 
to disorganization, and the formation of abscesses and sinuses in 
aU directions." — (Spence's Lectures on Surgery.) 

My object in describing this comparison between the white 
swelling of the human joints and the disorganization that so 
frequently succeeds neurotomy, is to show how a similar patho- 
logical condition may be induced by a circumstance which at 
first seems to be so very dissimilar; — in the human being, a 
constitutional taint ; in the horse, removal of a portion of the 
sentient nerve. Further inquiry may discover that the disease 
from constitutional taint is in reality due to altered innervation 
consequent upon that taiut. 

The rupture of the tendon is due to a slow degenerative pro- 
cess, and not to a sudden snapping of its fibres, as was formerly 
taught. 

Now and then, however, sudden rupture of the tendon takes 
place immediately after the operation ; but this is rare in com- 
parison with the degenerative process, which not only involves 
the tendon, navicular bone and ligaments, but all the surround- 
ing structures of the foot and pastern. 



GELATINOUS DEGENEKATIOJf. 355 

In the dissection of the foot from which the figure was drawn, 
the navicular bone was fractured, and the inferior broad liga- 
ment ruptured. Neither of these results was due to violence, 
for the animal had been at rest for several weeks prior to its 
death, and the various changes had come on gradually. 

Another unfavourable result of the operation is loss of the 
hoof from suppuration induced by accidental injuries to the foot, 
or from morbid action in the tissues, deprived of their nervous 
sensibility. 

In some cases regeneration of the nerve substance occurs ; the 
divided ends become continuous by growth from their extremi- 
ties, the nervous current is re-established, and the lameness 
recurs. These results, however, do not take place for at least 
two years after the operation is performed. If the lameness is 
severe, it may be necessary to excise the reunited nerves, and 
thus again destroy the sentient communication between the 
diseased part and the nervous centres. It has been already 
shown that fracture of the navicular bone, when unaccompanied 
by degenerative disease of the bursa and tendon, may not inter- 
fere with the animal's usefulness ; the fractures, as in Figs. 15 
and 16, being united by a false joint, and the animal continuing 
to perform his daily task with apparent ease and comfort. 

My experience leads me to the conclusion that the lameness 
arising from ring-bones or side-bones, when the feet are good 
and strong, is generally permanently benefited by neurotomy, 
the animal restored to its fuU usefulness, and remaining sound 
for many years. Indeed, in ring-bone lameness I have repeatedly 
noticed that not only has the lameness been entirely cured, but 
that there has been a gradual absorption of the osseous new 
formation, and a restoration of the pastern almost to its natural 
shape and dimensions. When the operation has been performed 
for the relief of these lamenesses, there appears to be an absence 
of any tendency to gelatinous degeneration or other alteration of 
structure. 



CHAPTEE XIX. 

DISEASES OF THE FEET — continued. 

INFLAMMATION OF THE FEET DIVISIONS OF LAMINITIS PATHOLOGICAL 

CHANGES CAUSES SYMPTOMS TREATMENT ME,. BROAD's 

TREATMENT. 

LAMINITIS, OR INFLAMMATION OF THE FEET. 

Inflammation of the feet, independent of its subdivisions into 
acute, subacute, and chronic, is of two kinds, namely, inflam- 
mation primarily limited to the sensitive laminae and sensi- 
tive sole; and ostitis, or inflammation involving the os pedis, 
laminae, and sole from the very outset. The causes, course, 
and tractability of the two forms differ; but the first, if not 
subdued in a short time, is apt to become developed into the 
latter. 

"Laminitis is one of the most dreadful diseases the horse is 
liable to, and is not confined to the feet, although its chief 
seat is there. It is caused by over-exertion, inordinate feed- 
ing, drinking cold water when heated, long voyages, from the 
horse being compelled to stand in a constrained position, or a 
sudden chill. It is often communicated to the feet from inter- 
nal organs, as from pneumonia, enteritis or bronchitis ; in this 
case the feet are affected as well as the whole surface of the 
body, the hair of the mane and tail being often thrown off, 
and the tendency of laminitis is to throw off the hoof, as well 
as the common integuments, in consequence of the general 
irritation." — (Professor Dick.) 

Laminitis, arising from over-exertion and from the con- 
cussion of hard galloping on the road, as in those reprehensible 
cases where horses are run against time, is much more intract- 
able than when it appears during diseases of the mucous 
membranes, when it may pass off as a mere congestive attack, 
without leaving any structural change ; whilst the form caused 
by concussion leads to ostitis of the most acute kind, sometimes 
terminating in necrosis of the pedal bone, sloughing of the hoof, 
and a most agonising death. Tlie symptoms of both varieties 
are identical, except in their severity, and if the so-called meta- 



LAMINITIS. 357 

static form continues long enough, the pathological changes are 
the same also. 

Pathology. — Inflammation of the sensitive foot, including 
laminae, sole, and os pedis. The exudation is greatest at the 
toe, the foot being most vascular at this point. The pain of 
laminitis is most agonising and persistent, because the sensitive 
foot is invested with an unyielding horny box pressing upon the 
engorged blood-vessels, preventing free exudation and swelling, 
and thus proving a barrier to the method by which congested 
blood-vessels are relieved. The exudate in laminitis is found 
to limit itself to the external surfaces of the sensitive laminae, 
but in that form caused by violent concussion, and which with 
propriety might be termed " peditis," the exudation may be 
subperiosteal, detaching the periosteum from the pedal bone 
by the outpouring of an unhealthy, broken-down, dirty reddish 
coloured fluid ; whilst the interstices of the bone, its canals, and 
lacunae are filled with the same material, forming a barrier to the 
free circulation of the blood, and thus assist in hastening the 
process of necrosis and sloughing. 

Mere laminitis may pass off without causing structural 
change ; there is but a slight exudate, and this is soon absorbed 
after the subsidence of the inflammatory action. In some 
cases the removal of the exudate leaves a space between the 
sensitive and horny laminae, which has led some observers to 
think that the disease consists essentially of absorption of the 
bond of union between the two sets of laminae, the formation 
of a cavity, and the subsequent filling up of it with imperfect 
cheesy or seedy horn. 

Should the inflammation persist, the exudate accumulates at 
the toe, increases in thickness, presses upon the toe of the os 
pedis in the one direction, and upon the crust in the other, 
separating the two, forcing the toe of the bone downwards, and, 
later on, the toe of the crust upwards. The effect of this change 
in the position of the bone is the formation of a convex sole. 
The sole, being pressed upon by the point of the bone, is forced 
downwards, losing its natural concave shape; whilst from the 
secretory powers of the sensitive sole becoming interfered with, 
partly arrested or perverted, the horny sole remains thin, weak, 
cheesy, or spongy, like macerated horn, or even grumous, afford- 
ing but little protection to the sensitive parts within. The outer 
horn of the wall, namely, that secreted by the coronary band 



358 



DISEASES OF THE FEET. 




Tig. 67. 






^5 


^^\^ 








^^^ 
C.^ 


"^^i 


^ 




mm 






6Sa. 


Ik 

Ik 



Fig. 67 represents a section of the foot with its various parts in a healthy 
condition, and in their proper relative positions. 

Fig. 68. — Formation of a horny exudate at the toe, causing alteration in the 
several positions of the os pedis, wall and sole, and the formation of convex or 
" pumiced" sole. Whilst this process is going on, the extensor pedis is elongated, 
and the flexors thrown into a passive condition. 

FlQ. 68a. — Perforation of the homy sole by the toe of the pedal bone, due to the 
pressure of the new formation. — {College Museum.) 



LAMINITIS. 



359 



now presents characteristic appearances ; it becomes rihbed, as 
if tliere were successive efforts to cast the hoofs. The rings of 
laminitis are irregular, and run together towards the anterior 
aspect of the foot, as in the annexed illustration (Fig. 69). This 





'-«i. 



Fig. 69. 

distinguishes them from the rings of a healthy unrasped foot, 
in which they are regular, and have wider interspaces. 

The bone, pressed downwards by the exudate, becomes 
absorbed at its borders, by which it is reduced in bulk, more 

d 




Fig. 70. — Absorption of inferior edge of os pedis, a, 
Anterior aspect, b, Plantar edge ; the dark shade repre- 
sents a hollow space from -which the bone has been absorbed, 
c, Basilar process, d, Pyramidal process. 

particularly at its toe and sides, whilst its whole structure 
becomes brittle (Is;;.) by ossification of the exudate within its 



360 DISEASES OF THE FEET. 

interstices ; and (2d) by removal or absorption, as already 
described under Navicular Disease. 

In addition to the results indicated by the above-described 
pathological changes, ossification of the sensitive laminse and 




Via. 71 repreaents a more advanced atrophied or absorbed 
condition of the bone, with ossification of the laminse. 

suppuration are occasionally found, the latter occurring more 
especially at the coronet, detaching a small portion of the upper 
part of the wall ; whilst in other instances a serous fluid collects 
between the sensitive and horny soles and frogs, and detaches 
them from each other. 

Direct concussion causes laminitis, by its effects upon all the 
structures of the feet. Usually this form is confined to the two 
fore feet. But we must look further into the question, to under- 
stand the operation of inflammation, or even irritation of an 
internal organ, in the causation of this disease. 

Many writers state that affections of a serous membrane, 
such as the pleura, terminate, by metastasis, in laminitis. I 
have carefully studied the question for some years, and have 
arrived at the conclusion that such is not the case ; that when 
the feet become inflamed during the progress of another disease, 
a mucous membrane is involved, and that the inflammation of 
the laminae is due to an extension of the irritation from its 
primary seat to the laminae of the feet, as explained by Professor 
Diclc in the words already quoted, namely, " The feet are 
affected, as weU as the whole surface of the body, the hair of 
the mane and tail being often thrown off." To explain this,, 
it will be necessary to remember that the skin, mucous structures, 
and laminae are continuous one with another, and secretqi^^ ; 
the nature of their secretions being similar, namely, epithefium 



LAMINITIS. 861 

secreted by the mucous membranes ; scales of the same nature, 
by the skin ; and horn cells, similar in every respect to those of 
the skin and mucous membranes, by the laminae. It must also 
be remembered that when a part only is irritated, the effects of 
such irritation tend to spread, and that when the mucous mem- 
branes of the intestinal, uterine, or respiratory passages are 
inflamed, the skin participates, as may be witnessed in many 
cases of cutaneous eruption from indigestion, catarrh, &c. The 
irritation of the cutaneous surface may be very slight, scarcely 
observable ; but the irritation of its foldings in the feet, sur- 
rounded by their unyielding case, becomes a source of great 
pain; in fact, it may be said that this slight sympathetic 
irritation becomes the cause of an acute inflammation, because 
located in unyielding structures. I am convinced there is no 
real metastatic transference of the inflammation from its original 
seat, for it is found, when horses die from super-purgation, 
diarrhoea, or other irritation of the intestinal mucous membrane, 
that laminitis is often present before death, and post mortem 
examinations of such reveal the presence of inflammation, both 
in the feet and in its original seat. It is not necessary to have 
an inflammatory disease of mucous tissue to induce fever in 
the feet ; a slight irritation, such as that of a moderate cathartic, 
being sufficient. I have several cases on record where a 
moderate dose of purgative medicine has caused inflammation 
of the feet, without seemingly stimulating the intestines to 
more than moderate purgation. That the skin is in an irritable 
condition is also proved by the tendency to the non-healing of 
wounds during laminitis, by the loss of hair, as pointed out 
by Professor Dick, and by the frequent occurrence of phlebitis, 
or inflammation of the jugular vein after bleeding from it in 
this disease. The wound in the skin made for the withdrawal 
of blood does not heal, but suppurates, and the diseased process 
extends to the venous coats. 

Acute laminitis terminates in resolution of the parts, or in 
that form which is termed subacute or chronic, in suppuration, 
and occasionally in gangrene. 

Chronic laminitis is that condition of the feet remaining 
after the subsidence of the febrile symptoms; or it may 
originate independently of an acute attack. Horses suffering 
from the chronic form are, however, subject to the acute from 



362 DISEASES OF THE FEET. 

the most trivial causes ; and the acute form, when caused by 
concussion, if the animal outlive the primary attack, commonly 
degenerates into the chronic. The pathological changes, namely, 
the descent of the toe of the pedal bone, the absorption of its 
borders, formation of convex and weak sole, and the organiza- 
tion of a large mass of imperfect horn at the toe, are identical 
in both forms, the difference being in the severity of the 
accompanying febrile disturbance, and in the time in which 
the changes are accomplished. 

The predisposition to inflammation of the feet is often trace- 
able to hereditary tendency and defective conformation, as well 
as to bad management of the feet. It is said that horses with 
wide feet are more liable to the disease than others. Such is 
not my experience. Indeed, it cannot be said that any one 
shape of foot is more susceptible than another. It is more 
commonly found iu heavy dray-horses than in those of a lighter 
breed, this being doubtless due to the great weight the feet of 
such are compelled to bear, weakened, as they often are, by 
paring of the sole. 

There are two other classes of horses which are very liable 
to the disease : — (1st.) The horse which has overgrown his breed, 
that is to say, an animal with the legs and feet of a well-bred 
and the body of a cart-horse; (2^.) Small ponies that are 
excessively fat. In both these instances the inflammation can 
only be attributed to the unnatural weight of the body being 
greater than the feet are able to bear. I feel satisfied, however, 
although the weight predisposes, that the removal of the solar 
horn is the exciting cause. When horse-shoers learn to discard 
the drawing-knife, laminitis, except from other clearly defined 
causes, will be much rarer than at present. 

The more immediately exciting causes are concussion, excite- 
ment, over-exertion, indigestion, more especially when caused 
by engorgement of the stomach with wheat, or any other cause 
of intestinal irritation, septic infection, and bad shoeing. 

Generally, the disease is confined to the two fore feet 
especially when caused by concussion ; but it is not very 
unusual to find all the four feet affected ; sometimes the hind 
feet only, and, in rare instances, one fore or one hind foot. 
When one foot only is affected, it is often due to an injury to the 



LAMINITIS. 363: 

opposite foot or limb, whicla compels the animal to throw all 
the weight of that part of his body upon the sound side. The 
soimd foot becomes inflamed, which is indicated by lameness, 
heat, and pain. Premonitory to the advent of the disease ia 
the sound foot, the patient will sometimes suddenly be seen 
to bear his weight upon the originally lame side, although the 
wound, open joint, or other injury from which he may be 
suffering, continues in all its severity. An ordinary observer 
will consider the animal to have been unexpectedly relieved 
of pain ; but in a short space of time the hitherto sound foot 
will be elevated from the ground, the animal at the same time 
evidencing agonising pain ; fever will set in, and the head will 
be pushed into a corner. These symptoms are manifested to a 
much severer degree when a hind foot is involved. To prevent 
this complication to a severe injury or lameness, the shoe is to 
be removed from the sound foot, which, in very aggravated 
cases of injury, may be placed in a soft poultice, or allowed to 
stand upon some soft substance. The leg must be bandaged ; 
and if the horse is unable to lie down, as will generally be the 
case when a hind limb is involved, he must be placed in slings. 
I once saw a case where the os pedis of the off hind foot had 
been forced through the horny sole, in consequence of the animal 
having received an injury to the near hind leg. The animal 
was young, and newly taken up to be broken-in. Through 
some oversight, the horse was shod upon both fore and the off 
hind feet, the near side foot, owing to the lameness in the leg, 
being left without the shoe. By this error extra weight was 
thrown upon the foot of the sound limb — ^thus elevated above 
its fellow by the shoe — ^which caused violent inflammation, and 
the destructive process above mentioned. The case is very 
instructive. 

Symptoms of Inflammation of loth Fore Feet. — The horse is 
excessively lame, almost immoveable, especially at starting ; he 
seems as if all his body were cramped ; stands with his hind 
legs drawn under the belly, and the fore feet advanced, in 
order to relieve them from the weight as much as possible; 
occasionally he may be seen to sway himself backwards, elevat- 
ing the toes, throw his weight for a moment upon the heels of 
the fore feet, and then assume his original position. If com- 
pelled to move, he elevates his feet with great difficulty, not 



3G4 DISEASES OF THE FEET. 

because the muscles of locomotion are inflamed, as is sometimes 
supposed, but because he requires aU his feet to be upon the 
ground at the same time to bear the weight of the body. He 
will often groan from pain, while sweats bedew the skin. 

To diagnose a case quickly, the best nethod is to push the 
horse backwards, when it will be seen at once that he will 
elevate his toes, and throw his weight upon the heels. The 
pulse of laminitis is fuU, strong, and accelerated; and it will 
maintain the character of strength and fulness even after general 
debility has manifested itself. 

In some instances the animal lies down upon its side, with 
the legs stretched out, for hours together, evidently feeling great 
relief from the assumption of this position; whilst in others, 
particularly during the earlier periods of the disease, it will 
stand persistently. 

When the hind feet only are affected, the patient stands with 
all his four feet together ; the fore ones are pushed under the 
body, and not extended forwards, as when they are inflamed; 
the hind ones are extended forwards, in order to throw the 
weight upon the heels. Many, especially students, suppose that 
when the hind feet are inflamed, the horse stands with them 
pushed backwards, to remove them from the centre of gravity as 
far as possible. Such is not the case, since this position would 
cause the weight to be borne by the toes, the part of the feet 
which he is most careful to relieve, as it is the very spot where 
the inflammation is most acute. The sufferings of the patient 
are even greater when the hind feet are affected, and usually 
the symptoms become greatly aggravated by the standing pos- 
ture. It is distressing to witness so much pain; the animal 
standing "all of a heap," with anxious eyes; now nervously 
elevating one foot from the ground, then its feUow ; its respira- 
tions hurried and nostrils dilated, in fact, " blowing," as vulgarly 
expressed ; when compelled to move, as soon as the toes of the 
hind feet are pressed to the ground, he takes a kind of a jump 
forwards, performing perhaps two or three automatic steps, from 
the agony of the pain. He rarely stands long when the hind 
feet are affected, and experiences immediate relief when recum- 
bent. Very often the pulse will fall twenty or thirty beats in 
the minute in the course of a quarter of an hour after he has 
assumed this position. 



LAMINITIS. 365 

When all four, feet are affected, the symptoms will consist of 
a combination of the foregoing, with local heat in aU the feet, 
some degree of throbbing of the plantar arteries, and tenderness 
upon manipulation, or to the touch of the hammer. 

Treatment. — Gentle purgatives. On no account must violent 
cathartics be given, since the operation of purgatives tend to 
laminitis, and they occasionally cause death when the disease 
itself has been of a tractable or even mild form. If the bowels 
are loaded, injections of warm water are very serviceable ; but if 
the constipation is not very urgent, they may be dispensed with, 

In addition to a mild aperient, febrifuges are to be adminis- 
tered ; and for the fever of laminitis I know of nothing which 
proves so effectual as the tincture of aconite, in small but re- 
peated doses. In that form arising from irritation of mucous 
membrane or indigestion, the bicarbonate of soda may be added 
to the aconite. If the pain be very severe, I think better 
results are obtained from opium or morphia than from aconite, 
which seems to act more by reducing fever than by allaying 
pain. This method of treatment, with poultices to the feet, and 
the apphcation of Mr. Broad's shoes, has proved of eminent 
service in the treatment of laminitis. 

Practitioners differ in opinion as to whether cold or warm 
poultices or baths should be applied. Some recommend 
cold, others prefer warm. Tor my own part I have found 
that pain and fever are more speedily removed by warm fomen- 
tations and poultices in the early stages, and the resolution of 
the inflammation is promoted by cold applications after the 
very urgent symptoms have passed off. There is no necessity 
to discuss the why and the wherefore of these two methods, 
suf&ce it that warmth has a soothing effect upon a part to which 
it is applied, and that this soothing of pain in laminitis is the 
first essential step in its treatment. 

Mr. Broad strongly recommends exercise, even in the earliest 
stage of the disease, and very urgently requests me to do so also, 
but, much as I respect Mr. Broad, I cannot alter the conclusion 
I have arrived at from much experience of the disease and its 
treatment. Mr. Broad assures me that he is always successful 
with exercise. I can only reiterate what I stated in the first 
edition of this work, that I am of opinion that Mr. Broad would 
even be more successful than he is, if he were to abandon this 



'366 DISEASES OF THE FEET. 

poTfcion of his treatment. If the disease were a mechanical 
congestion of the vessels, doubtless such congestion would be 
relieved by the motion of the limbs ; but we must look for some- 
thing more than congestion being the origin, namely, irritation, 
and to the fact that congestion is the result and not the cause of 
the disease. 

The necessity for bleeding in laminitis is a question upon which 
practitioners differ. Without discussing it, I may state that I 
consider local bleeding from the coronary plexus advantageous, 
relieving the congestion and alleviating pain. 

The treatment of laminitis has hitherto been often unsatisfac- 
tory ; but a short time ago a method was recommended by Mr. 
Broad, V.S., Bath, which at the time secured for him a fair share 
of abuse and condemnation ; one writer going so far as to state 
that he thought the Society for the Prevention of Cruelty to 
Animals ought to be informed about it. Fortunately, however, 
for Mr. Broad, none of his critics had ever tried the plan ; whilst 
others, less prejudiced, and quite as eminent in the profession, 
gave it a trial, and were satisfied that it was most successful 
when properly applied. 

Mr. Broad's Treatment. — Mr. Broad has kindly written out 
his method of treatment, and I give it here in liis own 
words : — 

"TREATMENT OF ACUTE LAMINITIS. 

" As early as possible get lightly nailed on the feet affected 
extremely stout, wide-webbed, and long bar shoes, made from 
iron about twice the ordinary thickness that the particular 
horses' shoes are made from; make them gradually thia from 
behind the quarters, so that the heel part of the shoes is wide 
and thin, and fitted rocker fashion, which enables the horse to 
throw his weight where he tries to, much better than he can in 
ordinary shoes or without any ; that is, off the pedal bone on 
to the soft elastic tissues and tendon behind it, which are 
much less vascular and sensitive. 

" The object of putting on very stout shoes is to lessen the 
jaX; as it more commonly occurs that the horse& are obliged to 
be exercised on hard ground, as soft is not obtainable near. 
(It is a generally acknowledged fact with practical men that 
stout shoes lessen the jar to the feet of horses working on 



LAMINITIS. 



S67 



pitching or hg,rd roads mncli more than light ones do.) If the 
case is not a severe one, plain shoes, made after the same 
fashion, will do, although I prefer the bar shoes. I sometimes 



Tig. 72. — Mr. Broad's shoe as described in the text. 

use leather soles, but not in aU cases. If the heels of the feet 
are very strong and high, lower them ; if not, don't cut or pare 
the feet in any way. I also give at once an ordinary dose of 
physic, and as soon as possible get the shoes on, and compel the 
animal to walk on soft ground, if obtainable ; if not, on the 
road or round the box for a short time, until a little of the 
soreness passes off ; for however difficult it may be for him to 
move at first, it always lessens from exercise. In severe cases ii 
is often necessary for a person to walk behind the animal for a 
short time to compel him to move on. Eegulate the amount 
of exercise according to circumstances; in a general way, give 
from half-an-hour to one and a half hours three times per day, 
allowing the horse to have a loose box when not at exercise. 
Eepeat the physic about the fourth day (depending in a mea- 
sure on tlie effects of the previous dose, although I never saw 
any iU effects from the repeated physicking in such cases), until 
the lameness is removed, and the horse fit to work, which he 
may do in the same shoes, or lighter ones made somewhat after 
the same fashion, as it will be better for the horse to do mode- 
rate work than to remain idle. In cases arising from meta- 
stasis, or excessively long journeys, where there is exhaustion, 
it is necessary to be very careful with regard to physicking. 
In country places, when there is a difficulty in getting the 
special shoes made quickly, the horse may be exercised in a 
field in his ordinary shoes, or without any, until the special 
slioes be made and put on. It is very essential that no time 
be lost before the treatment is commenced, for when the con- 
gestive stage has passed, and active inflammation is going on, 
it is necessary to be very caiitious with regard to exercise. If, 



368 DISEASES OF THE FEET. 

from neglect or improper treatment, separation at the coronet 
has commenced, or the pedal bone is so far displaced that there 
is danger of its toe protruding through the sole, or if it is already 
through, keep the special shoes on, dress daily with hot tar 
until the opening in the sole has been iiUed up, and a particle 
of horny matter thrown out and become dry ; after which, as 
soon as the horse can walk, get him into the wettest pasture 
that can be found, and if he is not excessively lame, take his 
shoes off, rasp the heel low, and shorten the toes, so as to bring 
the sole in contact with the ground. This operation is to be 
repeated every three or four weeks, which will in time ensure 
sound and perfect feet as before the attack occurred, notwith- 
standing that all four of the pedal bones may have protruded 
through the soles; but it may require from six to twelve 
months before a new wall has grown down perfect and the 
sensitive lamina recovered its normal exudative powers. If 
the feet are not properly and regularly attended to, they will 
not recover their natural shape, but will be deformed, especi- 
ally at the toes. A wet pasture is essential, as the horn will 
grow as much in one month as it would in three months on dry 
ground. 

" Should the horse be suitable for farm work, he may be used 
on soft land for months before he is fit for fast road work. 

"Subacute laminitis is, in the majority of cases, a transi- 
tional stage from the acute to the chronic. Very few cases 
remain subacute which begin as acute ; yet you may have cases 
the symptoms of which may be moderate in intensity, and to 
be considered as subacute from the beginning. 

"The treatment of subacute and chronic laminitis must be 
a modification of that of the acute disease." 

Like Mr. Broad I have treated a great number of horses 
suffering from laminitis, and very successfully without exercise. 
If a horse will not lie down of his own accord, he ought to be 
cast, when very often the relief which is thus obtained by him 
win cause him to remain recumbent for many hours or even 
days. If he lie down persistently he ought to be turned over 
every four hours or so, bedded on clean dry material, and pre- 
cautions taken against bruising or other injuries. If he be 
unable to urinate freely, the catheter must be inserted and the 
urine drawn off at least four times during the twenty-four hours. 



LAMINITIS. 369 

or more frequently if the animal express uneasiness and a desire 
to micturate. 

Every case of laminitis should, if possible, be stabled in a 
large, airy, well-ventilated loose box, the iloor covered with 
plenty of short straw, chaff, or other material that wiU not 
entangle the animal's feet and legs. 

I do not recommend slinging except in cases that wOl or can 
not lie down. 

If lameness threatens to remain, mild blisters may be applied 
to the coronets with advantage. 



2b 



CHAPTER XX. 

DISEASES OF THE FEET — continued. 

DISEASES OF THE HORN-SECEETIKG STRTJCTUKES VILLITIS CARBUNCLE 

OF CORONARY BAND — FALSE-QUARTER SAND-CRACK HORN 

TUMOURS SEEDY-TOE CORNS THRUSH CANKER. 

DISEASES OF THE HORN-SECEETING STEUCTUEES OF THE FEET. 

Laminitis, if confined to the soft structures of the foot, might 
with propriety be classified under this head ; but as it involves 
the pedal bones as well as the laminae, I have arranged it under 
the first division. 



INFLAMMATION OF THE CORONARY SUBSTANCE — ^VILLITIS 
(haycock) — COEONITIS. 

Seen in heavy cart-horses, and occasionally in better-bred 
ones. Symptoms — -harshness and brittleness of the crust; loss 
of toughness and pliability ; increased heat round the coronet 
and upper part of the crust; often a fulness of the coronary 
band, and tenderness on pressure ; a shuffling gait, if both fore 
feet are affected ; the heels are first put to the ground ; but not 
to the same extent as in laminitis ; a desquamation, or a ten- 
dency thereto, of the coronary substance, shown by a line of 
separation between it and the crust ; diminished secretion of 
horn ; and a peculiar striated or striped appearance of the crust, 
well described by Haycock in his essay on "Villitis." The 
peculiarity of gait is due to the animal trying to glide his feet 
along the ground. The duration of this form of lameness is 
variable, but it generally lasts a few weeks. It is distinguish- 
able from laminitis by the peculiar appearance of the crust, and 
the bulging round the coronet. 

Treatment. — Eest or removal of ordinary shoes ; poultices to 
the feet for a few days, and the application of Mr. Broad's 



VILLITIS. 371 

slices, either barred or open ; cold applications to the coronets ; 
and when the heat and tenderness have subsided, mUd blisters. 
To reduce any constitutional disturbance, and the local inflam- 
mation, purgatives may be given occasionally. If the animal 
does not become sound with this treatment, he nmst be allowed 
a run at grass. 



CARBUNCLE OF THE COEONAEY BAND,^ 

Called Furunculus by Mr M'Eachran, Montreal, attributed to 
frost-bites by others, consists of an oval or irregular portion ot 
the coronary substance becoming infiltrated with unhealthy 
lymph, forming at first a hard swelling of variable size, very 
painful ; sometimes extending all round the coronet ; or appear- 
ing at other times as several patches or spots of inflammation ; 
accompanied by great pain, lameness, and a high degree of 
febrile disturbanc-e. After a few days suppuration sets in, 
most commonly at several points, with ulceration of the soft- 
ened portions, forming so many apertures or sinuses, which 
discharge a thin, unhealthy, ichorous pus. The apertures en- 
large by ulceration or even sloughing of their borders, and by 
confluence constitute a most formidable looking and unhealthy 
wound. In aggravated and malignant cases, other inflammatory 
points appear upon the pastern and fetlock, extending in some 
instances as high as the knee or hock, causing sloughing of 
great patches of skin and subcutaneous tissues, exposing the 
tendons, nerves, blood-vessels, and even the cavities of the 
joints, and producing so high a state of fever and suffering as to 
destroy the animal's life. 

Mr. Eobinson of Greenock describes some of his cases to have 
presented the following symptoms : — Lameness and febrile dis- 
turbance. On examining the limb, the integuments, in some 
part between the knee or hock and the foot, wiU be found 
gangTenious, with a dew upon the surface ; sinking on pressure ; 
having, in fact, a doughy feel In a day or two a line of demar- 
cation makes it appearance, and separation of the gangrenous 
part takes place. When not involving the coronary substance, 
Mr. Eobinson says that the result was always favourable. 

^ Carbuncle of the coronary band is a disease similar to malignant onychia of 
the human being. 



372 DISEASES OF THE FEET. 

Treatment. — Poulticing at first, to encourage the separation ; 
afterwards digestives, to stimulate the granulations ; and finally 
mild astringent dressings. Mr. Eobinson's cases hare all oc- 
curred in the winter, and he attributes them to cold and wet. 
I have seen many cases at times when they could not be attri- 
buted to wet or cold, and which seemed to be unmistakeably due 
to a blood-poison ; they were also more malignant and unman- 
ageable than those witnessed by Mr. Eobinson. 

I believe this disease is hitheirto undescribed by any English 
author ; but I know several veterinarians who have met with 
cases of it as well as myself. 

I am inclined to think that it is due to a blood-poison 
similar to that of glanders and farcy, as it is oftenest seen in 
unhealthy situations, ill-ventUated stables, and in horses with 
bad or gross constitutions. I was inclined, when I first saw 
it, to attribute it to some injury to the parts, and to believe 
that the unhealthy aqtion was the consequence of such injury, 
or to the introduction of some deleterious material into the 
wound ; but further experience has convinced me that it often 
originates from constitutional causes, and that it is an inflam- 
mation of the coronary substances, due to the presence of some 
morbid material in the blood. If the attack be slight, the 
inflamed point limited, circumscribed, and surrounded by 
healthy tissue, recovery may be expected; but if there are 
several points, which by ulceration tend to coalesce, as well as 
extensive destruction of tissue, an unfavourable termination 
may be looked for. Even if recovery from the more immediately 
dangerous symptoms is obtained, such will be the destruction 
of the horn-secreting structures that the animal will be worth- 
less for the future ; therefore the treatment must be directed 
to the prevention of the spreading of the disease from its 
original point; and the best local remedy for this purpose is 
the nitrate of silver, freely applied in its undiluted state. 
After the free application of the caustic, the animal ought to be 
made to stand with the lame foot in cold water, for an hour 
at a time, repeatedly during the day; poultices are injurious, 
as they encourage the tendency to sloughing and ulceration. 
When the foot is removed from the cold water, the parts are to 
be dressed with a solution of the tincture of terchloride of iron. 
In aU cases of this description, removal of the shoe and ex- 



CAEBUNCLE OF COEONAEY BAND. 373" 

amination of the foot are imperative. The general febrile 
disturbances are to be combated by — 1st. A brisk cathartic; 
2d. Sedatives or anodynes, as the case may require — anodynes 
if the pain be acute, sedatives if the febrile symptoms pre- 
dominate. The caustic is to be applied every second day, until 
it is seen that the ulcerations are becoming healthy in appear- 
ance. I have tried the carbolic acid dressings, but they are 
not to be compared with the nitrate of silver, cold water, and 
astringents. It must be remembered that the caustic is not 
to be applied for the purpose of destroying healthy tissue, but 
to induce healthy action in what is already diseased ; it must 
therefore be used with cautious freedom. 

The appetite is to be stimulated by tempting food ; care must 
be taken not to let the strength be reduced by the want of 
proper nourishment ; and as soon as the most acute febrUe 
symptoms have passed off, tonics, especially the salts of iron, 
are to be given. The stable must be well ventilated, clean, and 
well drained ; in fact, the surroundings of the animal are to be 
of the best kind. 

The result of a modified form of this disease may be a false- 
quarter. 

FALSE-QUAETEE. 

This consists of one or more clefts or fissures ia any part of the 
crust or wall of the foot, due to the destruction of the secretory- 
coronary band. 

The horny wall or crust of the foot being secreted by the 
coronary substance, it naturally follows that when a part of it 
is destroyed, the part of the wall below the destroyed portion 
is no longer supplied with horn from above ; and this deficiency 
causes a chasm or fissure in the waU. It differs from " sand- 
crack " very materially ; is much wider at its base, and contains 
a modified condition of horn; that is, the horny laminae — 
secreted by the sensitive ones — denuded of their outer covering. 
The coronary band also shows a loss of substance corresponding 
to that in the crust. 

A horse having a " false-quarter," although he may not at the 
time show any signs of lameness, is to be considered unsound, 
since he is liable to become lame at any time, from injury to 
the thin horny covering of this part of the foot, which is also 



374 DISEASES OF THE FEET. 

more or less tender, and requires careful shoeing, in order that 
no undue weight be thrown upon the weakened portion. 

Causes. — Anything that destroys the integrity of the coronary 
substance, such as treads, quitters, &c. 

The treatment, if there be a wound, must be directed to the 
diseased coronet ; removing aU ragged edges, making the wound 
as level as possible, and moulding the parts into their natural 
condition, as nearly as can be done, by firm pressure ; bringing 
tlie edges of the wound together, and inducing it to heal by 
secondary adhesion. If the case be an old one, the gap in the 
coronet healed up, and filled with fibrous tissue, but little can 
be done, except fiUing the fissure with gutta-percha from time 
to time as occasion may require, and applying a bar shoe, so as 
to throw the bearing from the weak part. Blisters to tlie 
coronet are sometimes useful. 

Tricks are played upon feet of this kind ; false-quarters, sand- 
cracks, and seedy-toes are filled with gutta-percha, moulded to 
the part whilst warm, nicely filed or rasped when cold, and the 
whole surface of the foot blackened witli lamp-black and oil, or 
covered with tar. 

Caution. — Never examine a horse as to soundness if the feet 
are dirty, without having them washed. 



SAND-CEACK. 

A sand-crack consists of a fissure of greater or lesser extent 
in any part of the foot, commencing at the coronet, and generally 
found in the inner quarters of the fore and the toes of the 
hind feet, very rarely in the outer quarters. 

Professor Dick taught that "a sand-crack may happen in 
an instant, from a false step ; and hence a horse, though he may 
spring a sand-crack within an hour after purchase, cannot be 
returned on that account to the seller." This opinion is held 
by many other writers and teachers ; but it is incorrect, except 
in very rare instances. A sand-crack proceeds by slow degrees. 
Prior to its appearance, the horn is imperfectly secreted ; it is 
dry and brittle. Horn is built up of tubes matted together. 
These tubes are similar to hair, and are secreted by the same 
kind of cells. And "the same cell which forms the scaly 
epithelium, epidermis, and hair is utilized in buQding up the 



SAND-CRACK. 375 

homy structures. The special history of the horny appendages 
of animals consists therefore in the description of the form and 
disposition of the surfaces from which they spring. Whereas 
hairs have roots embedded in follicles, the horn tubes spring 
from papillse, which stud a surface extended over bony or fibro- 
elastic prominences." — (G-amgee.) 

Horn is often spoken of as "built of hairs firmly matted 
together " (Barlow). The horn tubes are united together by 
an inter-tubular substance composed of cells, and produced from 
the surface between the papillse. The wall, consisting of horn 
tubes and agglutinating inter-tubular substance, is secreted by 
the coronary substance, and is naturally tough, but breaks into 
fibres if it grows beyond its natural length. This is due to the 
crumbling of the inter-tubular substance. 

In order that normal horn be secreted, it is essential that 
the papillse and intermediate spaces in the coronary band, as 
well as the sensitive laminae, be in a healthy condition ; for it 
is found that the very tough and natural state of the wall is 
maintained and preserved by the continual addition to it of 
horny agglutinating cells, secreted by the sensitive laminae as 
it (the wall) descends over the foot. 

Having seen, then, that the horn is secreted by the papiUae 
and the inter-papiUary substance, the reader can understand 
that the brittle condition of the crust leading to sand-crack 
depends upon a perverted condition of the secreting structures. 

Some horses are very liable to these cracks; and when a cure has 
been apparently effected, they (the cracks) are very apt to return. 
Such may be said to be naturally predisposed ; but the cause 
must be looked for in the deteriorating effects of bad shoeing, 
especially in that method which ignores the weight-bearing 
properties of the sole. When the sole is weakened by the 
drawing-knife, and shoes applied to the feet, more especially the 
seated shoes which are put on the fore feet, the weight-bearing 
surface is limited to the thickness of the wall ; and an amount 
of weight is thus thrown on the crust calculated to overstrain 
it, and to induce diseased action in the structures to which it is 
attached, and by which it is secreted. Of itself horn is in- 
capable of diseased action, being a secreted and not a formative 
material. 

A sand-crack commences at the thin upper margin of the 



376 DISE.VSES OF THE FEET. 

■wall, and is usually small and insignificant at first j tut it / 
gradually extends downwards and inwards, and when it has 
penetrated through the horny structures, lameness becomes 
apparent ; inflammation is set up, both in the laminae and with- 
in the skin above the fissure ; the part is very painful, and the , 
lips of the wound, at its upper part, gape as the tissues swell. '' 

In some rare instances, however, lameness may be present 
before the appearance of the fissure. When such is the case, we 
may reasonably conclude that the fissure commences on the 
inner part of the wall, being the converse to the general rule. 

When the animal is made to move, the crack is seen to close 
every time the foot is put to the ground, and to open again 
when the weight is removed from it; during this closure the 
borders of the crack grasp some of the sensitive and swollen 
tissues, causing most excruciating pain and sometimes hsemorr- 
hase. Sand and dirt insinuate themselves into the wound, act 
as irritants, give rise to the suppurative action, and in some 
instances to a high degree of irritative fever. It is very painful 
to witness a horse, especially a heavy cart-horse, attempting to 
walk with sand-crack at the toe. Ho keeps the foot elevated 
from the ground as long as possible ; puts down the heel first 
very carefully ; and when the toe is forced to touch the ground, 
he immediately lifts the foot with a sudden catch, the pain 
being often so poignant as to cause him to groan. 

A sand-crack may occur through the bars, but it is very rare. 

Treatment. — If inflamed, remove all sources of irritation, and 
pare the edges of the crack if they press upon the tissues ; in 
fact, " bottom the cracJi," and allow the escape of pus, dirt, &c. ; 
remove the shoe, and give purgatives ; order fomentations and 
rest. A fungous growth is generally seen filling the fissure ; this 
is the result of the inflammation, depends upon it, and disap- 
pears upon its subsidence. It must not be destroyed by caustic, 
for the application will add to the irritation. When the inflam- 
mation and pain have subsided, place a bar shoe (thin heeled, 
with side clasps, if the crack be in the toe) on the foot, allow sole 
as well as frog pressure, but remove the pressure from that part of 
the foot immediately below the crack ; pare away the upper part 
of the crack from its coronary attachment, and let no direct 
communication remain between the fissured horn and the sub- 
stance from which new horn is to grow, or the crack wiD be 



SAND-CKACK. 377 

' perpetuated. A sand-crack never unites, and a new crust must 
be cultivated. 

There are two operations applicable to sand-crack after the 
inflammation has subsided, namely, the French plan of " strip- 
ping," and the English method of " clasping." The first should 
be performed only in very aggravated and long-standing cases. 
It consists in making a groove on either side of the crack ; the 
two grooves originating in a point about the middle of it, 
extending upwards to the coronet, and gradually diverging from 
each other, so as to include, at the coronet, nearly an inch of 
wall on either side of the fissure in the form of the letter V- 
The horn is to be cut completely through, and then the whole 
of it included in the grooves is to be stripped off from the point 
to the coronet.^ If any remains of the sand-crack he seen in 
the sensitive laminae, they are to be cut off with a sharp knife. 
Cold applications, bandages, and mild astringents, with rest, wiU 
constitute all the after treatment necessary ; time being allowed 
for the growth of new horn before the animal is put to work. 

The second method — that of " clasping" — is of two kinds, is 
much milder, and answers the purpose in the majority of cases. 
First performed as follows : — The horn immediately attached to 
the coronet above the crack is to be pared away, so as to com- 
pletely disconnect the diseased horn from the coronary sub- 
stance ; then a clasp is to be applied, which may now be obtained, 
with the necessary instruments, from any surgical instrument 
maker. The second, and the better when the horn is sufficiently 
thick, as when the crack is in the toe, is to cut a notch with the 
drawing-knife about half-an-inch from each side of the crack, as 
near the coronet as possible, and about a quarter of an inch 
deep, and sufficiently large to allow the imbedding of the 
head of a smaU horse-nail. If the crack be an old one and long, 
other notches are to be cut an inch lower down, and ordinary 
horse-nails, pointed with a broad point on the reverse side, are 
carefully driven into the horn through those notches, embracing 
both sides of the fissure, long clenches being left, and the crack 
drawn closely together with the pincers, the clenches fastened 
down, and the whole rasped smooth. The rationale of these 
methods is to prevent aU motion in the crack during the 
movements of the animal. In this way a horse may be em- 
ployed for his usual work during the growth of the new horn ; 

* It is now found that in many cases the grooves are quite suflScient without 
stripping the horn from between theni. 



378 



DISEASES OF THE FEET. 



whereas, if no clasp or nails be applied, lameness manifests 
itself, from the pinching of the sensitive laminae when the edges 
of the crack approximate each other at the time the foot is on 
the ground, as already explained. It is always necessary to see 
that no dirt insinuates itself into the foot through the fissure, 
and to keep it filled with some firmly adhesive material, such as 
gutta-percha. If the growth of horn seem inactive, a slight 
blister to the coronet will prove useful, by promoting a more 
rapid secretion. At all times, and for sand-cracks in any part of 
the foot, a bar shoe, if the frog is not diseased and unfit to bear 
pressure, is useful. In this, as in all other diseases of the feet, 
the sole is to remain unpared, and allowed to bear its due share 
of the animal's weight. When the crack is at the quarter a 
three-quartered bar shoe, to remove weight from it, is to be 
recommended. 



KERATOMA. 



The two following woodcuts, fac-similes of specimens in my 
possession, will illustrate this condition of the foot : — 




Fig. 73. 



Fig. 74. 



Fig. 73. — Homy foot, showing at a horn tumour. 

Fig. 74. — Pedal bone of same foot, showing a cavity at its toe corresponding to 
the horn tumour in Fig. 73. 



KERATOMA. 379 

The horn tumour seen in Pig. 73 is caused by pressure of the 
toe-clip of the shoe, this having been hammered too tightly by 
the smith, or becoming so by the animal strHdng the toe against 
the ground. These tumours and their corresponding gaps in the 
pedal bone are generally found in the toes of the hind feet ; but 
it is by no means an uncommon thing to find them in the fore 
feet, at the sides where the clips of the shoe are situated. I 
have a case now under treatment with two in each fore foot. 
Generally, a kind of fissure is seen in the outer shell of the M^all, 
or a concavity or depression without an actual fissure. There 
is sometimes lameness ; occasionally the animal goes sound, the 
absorption of the bone accommodating the horn tumour. A 
horse whose feet are in this state is unsound, as the growth of 
the tumour is apt to cause lameness. Now and then instances 
may be seen where there is no apparent cause, no pressure of the 
clip, the disease being apart from the portion of hoof upon which 
a clip is usually situated. These tumours are analogous to corns 
in the human feet, and consist of an increased secretion of horn, 
generally caused by pressure. 

If they cause lameness, a method of treatment is recom- 
mended, namely, the removal of the whole of the crust im- 
nicdiately over the diseased part, by cutting through it on either 
side from top to bottom, detaching it from the sole, and tearing 
it off, leaving the sensitive parts exposed. This operation is 
called " stripping the wall ;" it is a very cruel one, and should 
never be performed except where the disease has resisted other 
treatment, as it is sometimes followed by untoward and in-e- 
moveable results, which seem to have escaped the notice of those 
who advocate its performance, not only for horn tumours, but 
for seedy-toe and sand-crack. These results are — (1.) The 
formation of successive abscesses and fistulse in the coronary 
substance, before and during the growth of the new horn : (2.) 
Destruction of the sensitive laminae, non-secretion of the horny 
duplicates, and the consequent attaclmient of the horny wall to 
the OS pedis through the medium of a form of fibrous material, 
easily excited to inflammation and suppuration : (3.) Formation 
of abscesses at the coronet after the growth of the new wall, 
arising from the sensitive laminse, bruised and lacerated by the 
force of the operation, degenerating in some parts into circular 
fungoid masses, which by growth separate the wall from its 



380 DISEASES OF THE FEET. 

attachment, and occasion much lameness. It is, therefore, better 
to modify any lameness which they may occasion by properly 
adjusted shoes. Should these prove insufficient, the diseased 
portion may be isolated by grooving, as in the process of strip- 
ping, but the horn left unstripped. 



SEEDY-TOE. 

This term is applied to a perverted secretion of horn at the 
lower margin of the os pedis, by which the crust becomes de- 
tached from the horny laminse. 

It is often a result of laminitis, or of the pressure of the clip 
of the shoe. It consists in the formation, by the surfaces of the 
sensitive laminse, of a cheesy or mealy imperfect horn, which is 
incapable of maintaining the union between the outer wall and 
laminse. Being more rapidly secreted than healthy horn, it 
causes a separation of the crust from the laminse, and of the 
sole from the lower margin of the os pedis. Eapidly drying, it 
shrinks in bulk, causing a vacant space between them, which 
emits a hollow sound when percussion is applied to the wall. 
When very extensive, there is usuaUy a bulging of the wall at 
the part affected. 

Although called seedy-toe, iu is not coniined to that part of 
the foot, being often seen in other parts of it, especially the 
quarters. When not due to laminitis, or to the pressure of the 
clips, it originates in some inherent cause, such as weak feet, or 
in the weight-bearing surface of the foot being limited to the 
wall by bad shoeing. 

Lameness is not invariably present ; but it must always be 
considered an unsoundness, as it is easily aggravated, has a ten- 
dency to spread, and great lameness is produced by the insinua- 
tion of dirt and gravel. 

If treatment is to be adopted, it should consist in the removal 
of aU the diseased parts, and in the promotion of the growth 
of healthy horn by blisters and moisture. Bar shoes, sole 
pressure, and removal of shoe-clips are the instructions for the 
farrier. 

Some people think that white feet are more liable to suffer 
from seedy-toe than dark-coloured ones. This is a mistake, 
seedy-toe being as often found in dark as in white feet, in the 
fore as well as in the hind feet. 



CORNS. 



381 



CORNS. 

A corn is tlie result of a bruise, involving the structures of the 
sensitive sole, appearing as an ecchymosed spot in the triangular 
space included between tlie bars and the wall at the heel ; oc- 
curring in the fore feet, and almost invariably in the inside heel ; 
and caused by bad shoeing. Corns are not horn tumours, as 
taught by Gamgee and others, but they may become so, if tlie 
cause be long applied. 

The ordinary seated shoe is the most irrational invention that 
ever emanated from a man's brain. It is a thing that bears 
upon no part of the sole except upon the spot that is incapable 
of bearing such pressiire. It is dished out — made concave — all 
round the foot except at the heels ; and the result is corns. A 
corn consists essentially at first of a bruise and extravasation of 
blood, from rapture of the small vessels, which insinuates itself 




Fig. 75. 



into the horny texture, and gives it the characteristic red appear- 
ance ; it terminates occasionally in suppuration, partial necrosis, 
horn tumour, or in the formation of bony spiculse on the plantar 
surface of the pedal bone, as represented in the sketch. 



L 



382 DISEASES OF THE FEET. 

A corn constitutes an unsoundness, although it may not at the 
time cause lameness. 

TrmtTmnt. — If inflamnaation be present, treat accordingly; 
remove shoes ; poultice, &c. Give exit to pus if the corns have 
festered ; and if there be superficial necrosis of the pedal bone, 
the sequestrum must be removed. The radical cure, however, 
is to be efi'ected by proper shoeing, and the method already laid 
down is certain, speedy, and recommends itself to all impartial 
men. Horses that are high steppers, with heel action, are most 
susceptible to corns, especially if weak in the heels ; but corns 
are seen in the best of feet, and they will continue to be seen 
while horses are shod with the seated shoe. One other cause 
of corns is the maceration of the feet by vile combinations called 
" stoppings," which cannot be too strongly condemned. 



THEUSH. 

A discharge of a foetid material from the frog, arising from a 
diseased condition of the secretory surface of the fibro-fatty frog. 
The cleft is the part commonly first affected, and when neglected 
the disease spreads over the whole organ ; the horn becoming 
detached from the bulbs of the heels to the toe of the frog. 
The causes are extrinsic and intrinsic. The extrinsic causes are 
lilth, the irritating materials generated in the decomposition of 
the urine and fseces, and contained in stoppings for the feet, such 
as cow-dung, and maceration of the frog, as when the animal is 
turned out to a wet pasture : these causes operate by destroying 
the integrity of the horny frog, and irritating its sensitive 
counterpart. Thrushes from extrinsic causes are more com- 
monly found in the hind than in the fore feet, because the latter 
are not in the dirt whUe the animal is in the stable. The intrinsic 
causes operate chiefly on the fore feet, — although thrushes may 
be seen in the fore feet if the animal be at grass, in a wet straw- 
yard, or in a dirty loose box. In the winter time the frog 
denuded of its horn becomes occasionally frost-bitten, leading 
to deep sloughing, which may even extend to the navicular bursa, 
and causing great lameness. 

Thrushes are easily cured, when originating from external 
causes, by cleanliness, and calomel locally applied ; and if it be 
impossible to prevent the animal from standing in his excreta. 



THRUSH, 383 

leather soles should be used ; these may he moveable, and used 
only while the horse is in the stable. 

"When, from the intrinsic cause already referred to, or from 
some habit of body (cachexia), with swelling of the legs, or 
grease, the cure becomes a difficult matter, purgatives, dress- 
ing with calomel, tonics if necessary, regular exercise, and great 
cleanliness, will be necessary. 



CANKER 

Differs from thrush in the nature of the diseased secretion, in 
its course and tractability. It usually commences in the frog, 
and rapidly extends to the sole, and even the sensitive laminae ; 
but it is not a rare thing to see it commencing in any other 
part of the plantar surface, or of the laminated structure of the 
wall, excited by a wound, prick, or other injury. It much 
resembles grease of the leg, both in its nature and the class of 
animal it attacks ; and very frequently both conditions are co- 
existent. I have investigated the condition of the parts micro- 
scopically, but have failed to detect any malignant characteristic. 
The papillae are enlarged by engorgement, or by hypertrophy, 
but show no trace of cancer or malignant disease ; nor of lym- 
phoid or tubercular deposition, as in some cases of foul in the 
feet of horned cattle. In some instances such bodies, like the 
sporules of a vegetable parasite, are to be seen under the micro- 
scope ; perhaps further research will demonstrate that canker is 
due to the presence of a cryptogam. 

The characteristic symptoms of the disease are strongly 
marked, and consist of an abundant fcetid, colourless discharge 
from the frog, which is large, spongy, and covered by palhd, 
stringy prominences of a fungoid nature, intermixed with offen- 
sively smelling, semi dried, cheesy masses of matter, composed 
of imperfect horn cells. It seems as if the various constituents 
of the horn were in an uncombined state ; the sulphur, which 
is a natural constituent, being secreted as sulphuretted hydro- 
gen, giving the characteristic foetor to the whole secreted mass ; 
the horny matter imperfect, and floating in an abundant 
liquid material ; the secreting villi enlarged, scantily covered by 
a thin pellicle of horn, giving them superficially a white appear- 
ance, whilst underneath they are turgid, congested, and humid. 



384 DISEASES OF TIIE EEET. 

Canker may be confined to one foot. When resulting from 
an injury it is always so ; but -when originating from no osten- 
sible cause, two, three, or even all the feet, may be contem- 
poraneously or successively affected. The sound feet of a horse 
predisposed to canker very often have an abominable smell, as 
if the animal suffered from a sulphuretted hydrogen diathesis. I 
have coined tliis term, not being able to find another to express 
my meaning. 

Canker is generally confined to heavy cart-horses. Some 
writers say that neglected thrushes are apt to run on to canker, 
I am, however, of opinion that such is not the case, unless there 
be a strong predisposition; and when tliis is present, thrush, or 
even an injury, may excite its development. Canker is a 
constitutional disease located in the feet, and is due to a 
cachexia or habit of body, grossness of constitution, as exhibited 
by thick round legs, large feet, and the lymphatic temperament. 

The treatment of canker is early extirpation, not only of the 
diseased surface, but of the whole horny solar aspect of the foot, 
and is performed as follows : — With a sharp drawing-knife make 
a groove at the immediate junction of the sole and wall all round 
the foot, commencing at the heel, extending round the toe, and 
to the other heel. Then divide the circle into two halves, by 
making another groove from the cleft of the frog to the toe of 
the foot. The patient must now be cast and properly secured. 
Then with a sharp scalpel cut cleanly through the grooves into 
the sensitive parts, so as to completely separate the sole from 
the wall. When this is done, strip off one-half of the sole first, 
and then the other half, removing every trace of the horny 
covering of both sole and frog. It must be done thoroughly and 
effectually. Cut away all fungous growths, and dress the whole 
of the exposed surface with the nitrate of sUver. Pack up with 
dry tow, bandage, and put on a leather boot. Apply moderate 
pressure to the fetlock by a tourniq[uet, to prevent excessive 
haemorrhage. I find it unnecessary to do this until after the 
operation is completed, as bleeding does not begin until the 
animal is on its feet again. Two days after the operation, the 
dressings are to be thoroughly soaked in warm water for an hour, 
and carefully removed. If removed dry, they are apt to tear 
away pieces of the textures, to which they are firmly agglutinated 
by the dried blood. Great care must be exercised in doing this, 



CANKER. 385 

as everything torn now leaves a raw surface difficult to heaL In 
some instances the whole of the exposed surface of the foot 
presents a beautifully healthy appearance, and become gradually 
covered with natural horn, with very little more treatment than 
cleanliness, mild astringents, and moderately firm pressure. But 
the more aggravated ones wiU continue to present fungoid ele- 
vations and morbid secretion, requiring repeated dressings with 
powerful caustics and astringents. Chromic acid, carefully 
applied in its undiluted state, is a good remedy, combiaing with 
the watery constituents of the fungoid growths, and stimulating 
the production of healthy horn. It must be sparingly applied, 
as its affinity for water is so great as to cause a blaze of fire by 
the intensity of their combination. For at least a week after the 
operation, the horse should stand without shoes, the soles being 
padded with tow, bandaged, and booted ; but when the feet are 
able to bear the shoes, they should be put on, since it is much 
easier to dress the feet when they are on. The after treatment 
win depend very much on the progress of the disease ; remedies 
seem to lose their effect after two or three applications, and re- 
quire to be changed. When the chromic acid seems inoperative, 
a mixture of sulphuric acid and tar might be tried, or the acid 
carefully put on in its undiluted state. Care, however, must be 
taken not to continue caustic and escharotic dressings too long, 
or the whole sensitive sole will be destroyed, necrosis of the 
bone produced, with great sloughing, and perhaps the death of 
the horse. Burnt alum, sulphate of copper, terchloride of iron, 
chloride of zinc, sulphate of iron, tannic acid, and other astrin- 
gents, with an occasional application of carbolic acid, might be 
tried in their turn. Some cases improve under firm pressure, by 
means of pledgets of tow and splints ; whilst in others, pressure 
seems to stimulate the diseased action and the production of 
fungus. There is scarcely a rule which can be laid down. 
Much depends on the skill of the veterinary attendant. The 
stripping must not, however, be forgotten, and it may be neces- 
sary to repeat the operation. Many horses have recovered that 
have required it to be done three, or even more times. When 
the laminse are involved, the case may be generally looked upon 
as hopeless ; but if treatment is determined upon, the crust must 
be stripped, so as to expose the whole of the diseased surface. 
The constitution, being the source and origin of the ailment, 

2c 



386 DISEASES OF THE TEET. 

must not be forgotten. Purgatives, diuretics, tonics, alteratives, 
such as arsenic and deobstruents, are to be employed to get it 
into a good state of health, with regular exercise, good dry food, 
great cleanliness, and a dry situation. In all cases of canker the 
dressings should be removed daily ; and when pressure or pro- 
tection by an artificial sole seems hurtful, the foot should be left 
uncovered, dressed over with tar, and repeatedly cleansed with 
cold water every day. If in a fore foot, this is easily done ; but 
a hind foot requires more trouble and care. When a thin pellicle 
of horn has formed, gentle pressure, by means of pledgets of tow 
dipped in tar, will prove useful in aU cases. Such pressure may 
be constant or intermitting, as the discretion of the practitioner 
may lead him to prescribe. 



CHAPTER XXI. 
DISEASES OF THE FEET — continued. 

PUNCTURES or THE FEET BY " GATHERED NAILS " AND BY " PRICKS " IN 

SHOEING IMPORTANCE OF THOROUGHLY EXAMINING WOUNDED 

FEET AND OF GIVING EXIT TO ALL DISCHARGES WEAK FEET 

LIABLE TO INJURIES — QUITTOR TREATMENT FOUL IN THE FOOT 

OF HORNED CATTLE FOOT-EOT IN SHEEP. 

PRICKS IN SHOEING AND GATHERED NAILS. 

A " GATHERED NAIL " may pierce any part of tlie sole or frog, but 
most commonly it is found to have entered one of the commis- 
sures of the frog, and about midway between its toe and the 
bulb of the heel. If the puncture be deep, there is great risk of 
its penetrating the navicular bursa. The treatment is removal 
of the nail, paring of the part to allow the escape of pus, 
poultices, and rest. 

Punctures or pricks in shoeing are of two kinds, namely, those 
actually penetrating the sensitive structures, and those where the 
nails, not actually penetrating the sensitive parts, are driven so 
near as to cause bulging of the inner layer of horn, and pressure 
upon the sensitive interior, leading on to inflammation and great 
lameness, with or without suppuration. 

Many cases of pricks are caused by what are termed " drawn 
naUs;" that is to say, the smith, finding that his nail has gone too 
near, or even penetrated the sensitive foot, draws it out and 
drives it in again, taking a more superficial hold of the horn. 
These cases are more difficult to diagnose than when the nail 
causing the injury is not removed ; but with care it can be seen 
that, although the nail-hole is pared out, a stellate discoloration 
remains at the bottom of the cavity made by the knife. This 
must be followed and thoroughly bottomed, or the suppuration 



- i T^-O^V.iibW 



388 DISEASES OF THE FEET. 

imprisoned within the horny foot will cause acute pain, great 
lameness, violent febrile symptoms, and even death from pain 
and nervous exhaustion; or the pus may extend upwards 
along the laminae, detaching the horny structures from their 
attacliments, finally appearing at the coronet as a soft tumour, 
which, if pressed upon, wiU discharge first a sero-sanguineous 
matter and pus. Sometimes this discharge affords relief, but 
at others the suppurative action extends round the coronet, 
breaking out in various sinuses and unhealthy-looking 
abscesses ; the animal at the same time suffering from a con- 
tinuation of the pain and febrile symptoms, becomes rapidly 
emaciated, and from continual lying down covered with bruises 
and sores. 

To detect punctured wounds of the feet it is necessary to 
remove the shoe from the foot affected, then to examine all 
round the margin of the sole, by pressing it and the crust with 
the pincers. When the seat of the mischief is pressed upon, the 
horse will generally evince pain ; but the test is not to be de- 
pended upon until the sole has been pared out. 

" Pricks in shoeing" usually manifest themselves shortly after 
the horse has been shod ; but occasionally there may be no 
signs for three or four weeks, or even longer ; and in some horses, 
especially if the puncture be at the toe, the suppuration will 
appear at the coronet as the first symptom of mischief. This 
fact has led some writers to suppose that, because the burrowing 
of the pus does no mischief in these exceptional cases, it is good 
practice to allow every case to go on unchecked, until the pus 
has forced its way upwards and discharged itself at the coronet. 
I am surprised to find that such an idea has gained ground 
latterly, especially amongst the young members of the profession. 
It is full of error, founded on a very limited practical experi- 
ence, and calculated to entail much suffering on the poor patients, 
and to destroy many a valuable animal's life. The first step in 
the treatment of these accidents is to pare down to the bottom of 
the puncture, to allow the escape of the matter, which, by-the- 
by, is generally of a dark colour, and to place the foot in a 
poultice. Many cases, if so treated, are quite free from lame- 
ness in a day afterwards. A purgative is useful, removing 
sympathetic fever. 

Paring of the sole and removal of the horn allow the sensi- 



WEAK FEET. 389 

tive sole to bulge in the form of a fungoid granulation. To this 
caustic remedies are generally applied. Such applications are, 
however, calculated to do harm, as the supposed fungus is nothing 
more than the swoUen tissues, which disappear when the irrita- 
tion has subsided, lUce any other inflammatory swelling. How- 
ever, if, after the subsidence of the lameness and inflammation, 
the bulging still continues, the nitrate of silver or sulphate of 
copper and tar may be applied ; after which the part ought to 
be exposed to the drying influences of the air, when a scab will 
form, affording a natural protection to the tissues, wliich will now 
soon heal. 

In paring and searching lame feet, great care is to be taken not 
to make them bleed, as haemorrhage obscures the operation, and 
renders it a difficult matter to follow a small spot of discoloration 
to its termination ; and when the structures are wounded with 
the knife, they are apt to sprout up, inflame, and cause the healing 
process to be more prolonged than when the parts are carefully 
pared. 

Two or three sizes of " searches " are very useful ; the smaller 
ones, with double-cutting edges, to be employed in the more 
delicate and concluding part of the operation. 

In many cases of punctured foot it is necessary to apply the 
bar shoe for a few weeks in order to remove the pressure from 
the seat of injury, and to diffuse it over the frog and healthy part 
of the foot. Leather soles are also useful. 



WEAK FEET. 

Some horses have naturally weak feet, thin heels, and brittle 
walls, with a tendency to split up into layers where the nails are 
inserted. These feet require careful shoeing, with stout shoes, 
and leather soles adapted to their special peciiliarities. Horses 
that show tenderness or slight pain in the feet after work are 
much relieved and benefited by having their feet and legs 
bathed in water, or by being made to stand in a foot-bath for 
one or two hours at a time. 



QUITTOE, 

A fistulous wound upon the quarters and; heels of the coronet, 



390 DISEASES OF THE FEET. 

generally caused by treads, pricks in shoeing, suppurating corns, 
or any other injury calculated to excite the suppurative action 
within the foot, or in the structures of the coronet. 

The symptoms of quittor are lameness, swelling upon the 
coronet, ahout the centre of which one or more small orifices are 
seen, discharging either a thin limpid secretion, or a thick, perhaps 
curdled, pus. From the external orifices, sinuses are found 
leading generally in a downward direction, beneath the coronary 
substance, lateral cartilage, and into the foot itself. 

In many cases the animal is excessively lame, scarcely able to 
put the foot to the ground. 

A quittor differs from a wound, or a recent abscess on the 
coronet, by the condition of the parts, which have taken on a 
peculiar unhealthy action, by the character of the surrounding 
swelhng, which is hard to the touch, and by the presence of 
sinuses. 

The treatment will depend upon the cause. If it be any- 
thing within the foot, as a festered corn or a prick, a depending 
opening must be made at the sole, sufidciently large to allow the 
free escape of the contained pus. This, along with poultices for 
a few days, succeeded by a blister to the enlarged coronet, will 
often be sufficient ; the foot being protected in the meantime by 
a nicely adapted bar shoe, if it be too weak to go without. In 
all cases of injury to the feet, I think that if it be possible to 
do without the shoe it is better not to apply it ; but if the foot is 
broken, or if the application of the shoe be imperative, a nicely 
fitted bar shoe can be put on in such a manner as to remove 
weight and pressure from the seat of the injury or disease. 

In cases of quittor, where no communication exists between 
the wound and the plantar surface of the foot, it will be 
necessary for the practitioner to introduce his probe carefully, 
and to ascertain the depth and direction of the sinuses ; when 
he has satisfied himself on this point, the Bistouri cache (see Fig. 
76) is to be introduced as deeply into the sinuses as possible,. 




Fig. 76. 
the blade opened, and the parts cut as it is drawn outwards. 



QurrTOKS. 391 

The ordinary Bistouri cacM will not answer tlie purpose, as it 
does not cut to its point. The one delineated in the woodcut is 
specially adapted for quittors and other fistulous sores, as it cuts 
to its very point, a matter of great importance when it is neces- 
sary to bottom the wound. Very frequently the long continu- 
ance of quittor is due to the imprisonment of a piece of necrosed 
bone, dead cartilage, or other foreign body ; and it wiU be neces- 
sary to remove this before a cure can be effected. When the 
sinus has been opened to its extremity, it is good practice to inject 
into it a solution of the bichloride of mercury, 3i- ; water, §i. ; 
a few drops of hydrochloric acid being added to cause the salt 
to dissolve. One or two injections of this are sufficient to 
cause the whole exposed surface of the wound to cast off a thin 
slough, and to leave a healthy granulating surface, requiring no 
treatment beyond being kept clean. Much harm is done in these 
cases by the long-continued application of escharotics ; but 
should the wound look unhealthy after the separation of the 
slough, it may be necessary to apply the solution a second time. 
A glass syringe is the best instrument, as lead will be acted upon 
by the salt and the acid. 

Poultices assist the separation of the slough, and tend to 
soothe the irritation. They should therefore be applied for 
several days. 

In quittors of a very intractable nature the whole diseased 
structures, including the lateral cartilage, have to be removed by 
surgical operation, which is as follows : — The horse must be cast, 
a tourniquet applied to the fetlock; an incision is then to be made 
at the junction of the horny wall and coronary substance, im- 
mediately below the seat of disease, the skin is to be carefully 
dissected from the subcutaneous structures, and folded upwards 
in the form of a flap. When this is accomplished, the diseased 
portions are to be carefully removed with the scalpel, taking care 
not to penetrate the articulation, and the skin brought back to 
its original position, and retained there by firm but not too 
tight bandages. If the vessels are enlarged, as sometimes wiU 
be the case, they ought to be secured by ligature, but generally 
this is unnecessary, the haemorrhage being prevented by the 
bandage, and it is always better not to introduce a foreign body, 
as a ligature, into the wound. 

There are many unqualified men noted for their success in 



392 DISEASES OF THE FEET. 

the treatment of quittor. I knew of one, and he certainly 
managed to cure cases after everybody else had failed. His plan 
was a simple one, and consisted of the injection of a fluid — the 
composition of which was a secret — into the sinuses every four- 
teen days. He never allowed any interference with the foot 
during the interval, and seldom had to apply his remedy more 
than twice. I almost think that it was the tincture of the 
terchloride of iron. I deem it advisable, in cases of quittor, to 
make the incision into the sinus; but there are cases where these 
are too small and too numerous to admit of a satisfactory explora- 
tion. I'or such the old plan of " coring " will answer weU, and 
it is as foUows : — Powder some corrosive sublimate, or arsenious 
acid, or a mixture of both, veiy fine ; place a very little of the 
powder, say five grains, on a small square piece of tissue paper ; 
double this up cornerwise, and then fold into a stiff plug, 
pointed at one end. Introduce it as carefuUy and as deeply 
into the wound as possible, and, if necessary, apply a bandage 
to keep it in its place ; over the whole apply a poultice. In 
from five to seven days a circular slough wiU have separated, 
leaving the whole interior of the wound exposed to view. If 
this presents a uniform red appearance the sinuses have all been 
destroyed ; but if pale-looking spots or small apertures are seen 
in it, they indicate that more of the diseased surface requires 
destruction. This should now be carefully done, or the second 
slough may extend to important structures. When a healthy 
surface has been obtained, and the progress of the case stiU 
remains unsatisfactory, a blister must be applied to the coronet. 
This stimulates the reparative process, and removes pain and 
lameness. 

If any part of the crust should at any time press upon the 
textures involved in the diseased action, it is to be carefully 
thinned by the rasp. To sum up, the principles of treatment are 
as follows : — To make a depending orifice by incision, seton, or 
counter-opening, by seton or cautery remove all foreign bodies, 
to destroy unhealthy surfaces, aUay irritation, and finally to 
stimulate the reparative process. 

The vital powers and vascularity of the several structures 
involved vary to a great extent ; hence the practitioner some- 
times finds that, after doing all he can, the case progresses 
unsatisfactorily. I have in such instances found it advantageous 



QtriTTOES. 393 

to apply the actual cautery to the diseased structures, making a 
pointed iron, and pushing it, at a white heat, to the very bot- 
tom of the sinuses. The results from this have been satisfactory; 
the lameness has been relieved, the swelling removed, and 
healthy action set up in the wound. 

"When fistulous openings are situated upon or near to the 
anterior surface of the coronet, great care and discrimination must 
be brought to bear upon their treatment, as the pedal articula- 
tion is there superficially seated and thinly covered by soft 
structures, and a free application of an escharotic is sure to 
cause the slough to extend into the joint. 

No horse should work while suffering from quittor, as it not 
only causes great suffering to the poor animal, but renders 
recovery almost an impossibility. 



FOUL m THE FOOT 

Is a disease of horned cattle, and consists of inflammation and 
suppuration of the inter-digital substance, caused by over- 
growth of the hoof, which when elongated gives rise to strain 
and inflammation of the internal structures, the irritation of dirt 
confined between the digits, and in some instances tuberculosis. 
It extends by neglect or other causes into the various articula- 
tions and bones of the foot, producing great lameness, with much 
fever, loss of condition, and even death. It is most commonly 
seen in the hind feet, but it is not unusual to meet with it in 
the fore feet. 

In the majority of cases, if not caused by tubercular inflam- 
mation (see page 208), the disease, if attended to in time, is not 
so difacult to manage ; the treatment being the careful removal of 
all loose horn under which pus is seen to burrow, mild astrin- 
gents, poultices, and a purgative. In the more severe cases, 
where the inter-digital substance undergoes sloughing, the pro- 
cess must be assisted by warm poultices and fomentations. 
Afterwards the wound must be treated with astringents, great 
cleanliness, and protected by nice pledgets of tow steeped in a 
weak solution of carbolic acid, kept in their position by carefully 
adjusted bandages. There are other cases where the phalangeal 
bones are involved as high as the fetlock, with hard swelling of 
all the tissues, separation of the digits by enlargement of the 



394 DISEASES OF THE FEET. 

inter-digital substance, dislocation of the inter-phalangeal articu- 
lations, caries of the articular extremities of the bones, synovial 
discharge, necrosis of the canons, great suffering, and lameness. 
Cattle, whe'n so sorely troubled, wiU lie down, groan -with pain, 
and refuse to feed, the flesh quickly wasting ; great sores appear 
upon the various parts of the body on which they lie; and many 
will give up the battle altogether, and die right away as if their 
hearts were broken. Now, in such cases, whether the cause be 
tubercular deposition or not, the only method of cure is by 
amputation or disarticulation. I have performed these opera- 
tions with the greatest success, and I am thus in a position to 
suggest the best method. 

If the disease has not yet extended above the metacarpo- 
phalangeal articulation, the foot and pastern may be removed 
by disarticulation through the fetlock-joint; but if this joint 
be involved to any considerable extent, it will be necessary to 
amputate through the canon bone. The operation is as follows: 
— Before the animal is cast, the diseased limb must be protected 
by a bandage, and when the animal is down removed from the 
casting rope, fastened by a cord tied around the pastern, and 
held in position by two assistants ; a tourniquet is then to be 
applied above the seat of the intenjied section. The knife must 
be strong, with a narrow blade ; and care is to be taken that 
sufficient skin be left to form a good flap, so that the exposed 
end of the bone, as well as the soft parts, be completely covered 
when the edges of the wound are brought together. When the 
bone has been removed, the arteries are to be carefully taken up 
and secured by ligatures, and the whole extremity of the limb 
afterwards enveloped in carbolized lint or fine tow, firmly, but 
not too tightly, bound with a bandage. If the discharge is not 
very profuse, little after treatment is required, beyond cleanli- 
ness and occasional readjustment of the dressings. The animal 
must be well supported with nutritious food, and prepared for 
the butcher as quickly as possible. 

TuTTiours letween the claws of Cattle. — ^Hard nodules sometimes 
grow from the skin between the digits, causing a varying degree 
of lameness. They should be removed with the scalpel as early 
as possible. 



rOOT-EOT IN SHEEP. 395 



FOOT-ROT IN SHEEP. 

There are few diseases upon the nature and causes of which 
so much difference of opinion exists as upon this troublesome 
and vexatious source of loss. 

Continental, as well as some English and American veterinary 
writers and observers, divide foot-rot into two varieties, namely, 
contagious and non-contagious. 

The first or contagious form is called by a variety of names, 
as Paronclvyia ungularis ovium maligna or contagiosa (Latin) ; 
Pietin, Fietin contagieux, Mai de pied, &c. (French) ; Bosartige 
Klaueseuche der Schafe,&(i. (German); and the latter, Paronchyia 
inter-digitalis, or gravelling. 

Mr. George Fleming is the latest writer upon the subject, who 
has re-opened the question of the contagiousness of foot-rot, and 
in his work on Veterinary Sanitary Science and Police brings 
forward the opinions of Gohier, Chaumontel, Gasparin, Girard, 
Eeynal, Eandall (an American writer), and others, in support of 
its contagiousness ; but he seems to have passed over the deduc- 
tions of English writers for and against this hyothesis. Hogg, 
the Ettrick Shepherd, in his prize essay, communicated to the 
Highland and Agricultural Society of Scotland, was a firm 
believer in its contagiousness. Youatt seems to be uncertain 
upon the matter. Professor Brown, in an able essay published 
in the Journal of the Bath and West of England Society, as well 
as Professor Dick, unhesitatingly state that it is a non-contagious 
disease. 

In his lectures Professor Dick said as follows : — " Foot-rot is 
the name given to a disease in sheep similar to ' Foul in the 
foot' of horned cattle. Its consequences are disastrous and 
ruinous, attacking, if neglected, the whole flock, so that in feed- 
ing they actually crawl on their knees ; hence it is regarded in 
the last degree contagious. After a good deal of investigation, 
however, I have arrived at a different conclusion; and I discover in 
its history nothing more than the result of that domestic state to 
which the sheep has been subjected. By nature not unlike the 
goat, it frequents the summits of the lofty mountains, where its 
hoofs, altogether analogous to those of the horse, are exposed to 
much tear and wear. When from these alpine regions we 
transfer the sheep into our grassy lawns, our moorish lands, or 



396 DISEASES OF THE FEET. 

sandy soils, this wearing away of the crust is put an end to ; 
it grows too long, and proves a great encumbrance. In this 
state it is exposed to many injuries, among others from the long 
grass of the pastures, and itself necessarily injures the soft parts 
beneath ; and hence lameness, inflammation, suppuration, to the 
extent of casting the hoof, are the consequences. The circum- 
stance of the disease occiirring epidemically arises from the 
whole flock being placed in precisely similar circumstances." 

The late Mr. Eead of Crediton, in an essay on this subject, after 
very carefully weighing for and against contagiousness, says : — 
" For the last three or four years I have made every inquiry 
of men accustomed to sheep. Some say, on my asking their 
opinion, that it is as infectious as the plague ; for if they put a 
lot of sound ones with some that were lame, they all became so. 
But I have said — ' Perhaps the sheep with whom yours were 
put were in a soil favourable to the production of foot-rot, and 
yours were taken from a healthy soil.' Such was generally the 
case, and such is the proof which farmers and others pretend to 
give of its infectious nature. Little do they imagine what is 
the operating cause on a soil disposed to it. That which gives 
it to one will give it to a hundred if there is a predisposition to 
take it on." 

" My opinion is," concludes Mr. Eead, " that you may put 
lame sheep with sound ones on a healthy farm, and they will 
soon get well, and the others will not become infected." 

Mr. George Fleming brings forward some very strong facts in 
support of its contagious nature, and under the head of " Con-, 
tagium," says as follows: — " The contagium is present in the 
exudation from the diseased foot, and may be termed ' fixed.' 
It is transmissible either directly through contact of the diseased 
with healthy sheep, or indirectly through litter, pastures, roads, 
railway waggons, or cattle ships. It is also transmissible by 
' inoculation ' of the morbid fluid at the coronets of healthy 
sheep. Indeed, though numerous observations had previously 
demonstrated that the extension of the malady was due to the 
presence of a virulent element, it was not until inoculation was 
resorted to that this was received as a fact. Pictet was the first 
(in 1805) to publish observations in this direction. He received; 
two hundred half-bred merino sheep from Piedmont, some of 
which were lame from the disease. These were placed with a 



FOOT-EOT IN SHEEP. ' 397 

hundred other home sheep on a low hill, where the pasture was 
dry and of good quality; but in a short time the latter com- 
menced to have sore feet, and before long the whole three 
hundred were affected. The rams, which joined them after- 
wards, were also attacked. This occurrence having been made 
public, attention was directed to the contagiousness of the 
malady, and similar occurrences were soon made known, espe- 
cially by Girard. Gohier, to decide the question, undertook a 
series of experiments, after having published confirmative obser- 
vations. He removed shreds of the loose horn from the claws 
of diseased sheep, and fastened them between those which were 
quite healthy; in this way he produced the malady. As the 
question was a serious one for the agricultural interest of France, 
the Agricultural Society of Paris offered premiums for the best 
essay on the disease, and these were awarded (in 1823) to Favre 
and Sorillon. The experiments successfully carried out by these 
authorities were perfectly conclusive. Favre, for instance, in one 
of his trials, simply deposited the matter between the toes of 
thirty-two sheep; and twenty-one became affected. Then followed 
observations and experiments by Letzius, Giesker, Felix, Mathieu, 
Delafond, Charlier, and others. Eeynal has made numerous 
observations and direct experiments, which are entirely confirma- 
tive of all that had been previously published ; so that there is 
no doubt whatever as to the existence of a virulent element in 
the disease, and that to tliis it largely owes its extension. 

" Vitality of the Virus. — The virus of foot-rot appears to 
preserve its activity for a considerable period, though nothing 
definite has yet been arrived at in this respect. 

" Infection. — The virus does not appear to have any influence 
on other animals than sheep; no case of transmission, either 
naturally or by inoculation, having been recorded. Fine-wooled, 
high-bred sheep, as already noticed, are most readily infected, 
and lambs are also susceptible ; those with coarse wool are not 
only less readily infected, but they are more easily cured. 

" The power of the infection is shown in Favre's experiments, 
in which twenty-one out of thirty-two inoculated sheep become 
affected. 

" Mode of Access. — Infection takes place through the skin 
around the claws. There is no evidence to show that it can 
be produced in any other manner. 



398 DISEASES OF THE FEET. 

" Incubation. — The incubation stage is from three to six days. 

" Extension. — The disease is chiefly extended through traffic 
in sheep at the fairs and markets; by allowing diseased animals 
to travel in railway waggons and ships, and introducing healthy 
stock into these without a thorough cleansing having been 
carried out. Pastures on which affected sheep have grazed a 
short time previously have also been known to cause the disease 
in flocks succeeding them. Indeed, we can scarcely realise any 
more certain mode of extension than that of depasturing healthy 
sheep with diseased, or where the latter have been a short time 
before. The grass imbibes the discharge from the suppurating 
claws, and especially from between them, where it is most 
abundant and virulent ; and the healthy sheep, wallcing through 
the grass, must receive continuous applications of the virus from 
every blade, and on the very part where experiments have 
proved the skin to be most prompt and certain in absorbing it 
— ^between the toes. 

" Contact between, or mixing of, the sick and healthy, even for 
a brief period, on roads, at fairs, or on pastures, is also a prolific 
cause of extension. Litter, fodder, sheds, and stables must also 
be included among the media which harbour and convey the 
contagion. As has been remarked, the extension is facilitated 
by certain external influences." 

I have inserted these quotations in order that the reader may 
have both sides of the question. 

I think, however, that the direct inoculation, by means 
of shreds of loose horn or matter from diseased feet applied 
between the claws of feet that were healthy, proves nothing 
further than that discharge, in virtue of its irritating properties, 
induced inflammation of the inter-digital tissues in a manner 
similar to that which would restdt from the application of any 
common irritant, or even a foreign body, applied to and retained 
in the same place, and that the other facts are incomplete, as it 
is not stated whether the season was damp or dry. Professor 
Brown's opinion upon this question is well worth quoting. 
He says: — " The third position which we have undertaken to 
discuss will require but little consideration. It refers to the 
' virus ' of ' foot-rot,' — the animal poison supposed to be capable 
of inducing the disease by contact. 

" The question of the existence of such poison among the pro- 



FOOT-EOT IN SHEEP. 399 

ducts of foot-rot must be determined by experiment; and the 
only foundation for the assumption of ' virus ' lies in the fact 
that the introduction of the matter from a diseased foot to the 
healthy foot by puncture through the horn has prodi.ced foot-rot 
in some cases, although it has failed to do so in others. 

" After all, the fact may be admitted without any question ; 
it proves very little. We are quite prepared to learn that an 
injury to the horn of the foot, followed by the contact of a mix- 
ture of moist epithelial cells and particles of dirt, will, if applied 
sufficiently long, produce foot-rot; we know that dirt and moisture 
wiU suf&ce, without any additional elements. 

" Some of the experiments in inoculation failed, probably 
because there did not happen to be enough of the gritty particles ; 
others because they did not remain long enough in contact with 
the membrane to establish any irritation; and at best there 
was not so much disease produced as would have occurred if 
the animals had been placed upon undrained land, where there 
happened to be a tolerably plentiful admixture of sand or grit 
in the soil. 

" If it had ever been found that the introduction of the 
matter under the skin of the leg or any part of the body pro- 
duced the disease, there would be fair evidence of its specific 
nature; but in the absence of this proof, we cannot admit 
an assumption which is altogether unnecessary to explain the 
results. 

"From the present state of the argument, we may consis- 
tently deduce the conclusion that ' foot-rot ' is primarily con- 
sequent upon such a derangement of the structure of the horn 
as permits the introduction of foreign particles, which ultimately 
reach the internal membrane, and occasion irritation, followed 
by exudation and excessive secretion." 

For some time past my attention has been very much directed 
to this matter, and from my own observations, very carefully 
made, and from information gathered from many eminent flock- 
masters and their shepherds, I am quite satisfied that diseased 
sheep may, without fear of infection, be allowed to mix with 
sound ones on dry lands, and that consequently foot-rot is a 
non-contagious malady, and that it is manifested in two ways. 
First. Sheep pastured on gravelly or sharp sandy farms, wear 
away, especially in wet weather, the soles of their hoofs, and 



400 



DISEASES OF THE FEET. 



the sensitive parts become exposed; or if pastured on moor- 
lands, or soft parks, the wall grows too long, the sole, changed 
by moisture, affords but an imperfect protection to the sensitive 
structure within, permits the penetration of dirt, and occasion- 
ally, as stated by Professor Dick, the toe of one or both claws may 
bend upon the sole, and thus become a source of pain and inflam- 
mation. Fungoid growths appear on the exposed surfaces, the 
lameness increases, and there is loss of condition, as in the other 
form of the disease. 




Fig. 77. — Confirmed stage of the first form of foot-rot. 

The second and by far more common form of foot-rot is ex- 
pressed by inilammation and swelling of the inter-digital tissues, 
with at first but little visible alteration in the condition of the horny 




PlQ. 78 shows the condition of internal wall of 
digit in an early stage of the disease. 



sole, but the inflamed inter-digital structures soon suppurate, and 
discharge a foetid ichorous fluid, which burrows under the horn of 



FOOT-ROT IN SHEEP. 401 

the inner walls of the claws, and separates it from the sensitive 
structures within ; as in the other form, the exposed structures 
soon sprout, forming fungoid growths, which discharge a little 
fcetid ichor. 

The lameness increases in severity as the disease advances, 
and in a few days the animal presents a lank appearance, and 
begins to lose condition. 

In some cases the sensitive structures of the affected foot or 
feet lose their cohesion, and the horny walls hang loose around 
them, separated from the inflamed tissues within, except at the 
upper edge of the foot. The horny sole crumbles away as seen 
in Fig. 77, the sensitive tissues are exposed, and soon sprout as 
masses of fungus. The animal is now unable to put its lame 
feet to the ground, and will crawl on its knees, if the fore feet 
only be affected, and upon its abdomen, if the hind ones be the 
seat of the disease. 

If the hoofs are not shed, it is found that the continual irri- 
tation gives rise to an augmented but intermitting secretion of 
horn, the hoof becomes crooked, hard, deformed, large in size, 
and covered with rings. 

The disease — ^like that described by Mr. Fleming — "affects 
one or more feet ; but ordinarily one, and passes to the others ;" 
but sometimes only a single claw is affected. 

It is important that the differential symptoms of foot-rot and 
foot-and-mouth disease in sheep be correctly understood. 

From what has been stated, foot-rot commences either upon 
the solar aspect of the foot or in the inter-digital tissues. In the 
one case it begins below, in the other above; and by diffusion of 
the inflammation and burrowiag of the pus extends along the 
inner aspect of the digits downwards to the sole, and sometimes 
upwards through the coronary structures, forming sinuses and 
ulcers above the hoof, occasionally, but very rarely, involving 
the tendons and bones, and causing sloughing of the whole foot, 
there being at aL. times a strong tendency to the gxowth of 
fungus from every exposed part of the foot. 

Now, in foot-and-mouth disease — eczema contagiosa — the 
local symptoms are first manifested by redness of the 
skin surrounding the coronet, this redness commencing very 
often as a mere spot exactly above the inter-digital space, 
particularly at the heels, then extending all round the coro- 

2d 



402 DISEASES OF THE FEET. 

net and on the pastern; the redness is succeeded by an erup- 
tion, the crop of pimples or vesicles being generally more 
numerous above the bulbs of the heels. The eruptive stage 
does not continue long, the blisters burst or dry up and form 
a layer of scabs, which finally fall off or dessicate, leaving 
the parts more or less denuded of wool for some time subse- 
quently ; indeed it may be stated that the condition of the coro- 
nary skin is very similar to that which is induced by the action 
of an ordinary cantharides blister, and the changes occurring on 
the skin of the coronet may be classified under" four heads, 
namely, redness, vesication, scab, and dessication. 

The inflamed and vesicular condition of the skin is thought by 
some observers to extend into the sensitive foot, and no doubt this 
is a correct and proper view to take of the disease, .and accounts 
for the very severe lameness observable in the earlier stages, 
the early detachment of the horny digits from their connecting 
laminae,^ and for the presence of lameness in some instances 
before the occurrence of perceptible redness of the coronary sub- 
stance. Immediately on the appearance of vesication, and some- 




FlG. 79 showa the condition of a foot four weeks after 
the first or febrile stage. 

times even prior to that event, the horny walls separate, more 
particularly at the posterior part of the feet, sometimes very 
slightly, occasionally a mere line of attempted separation being 
observable, at other times more completely, from their attach- 

^ Vesication round the coronet should not necessarily produce separation of the 
horn therefroqj ; nor does it, unless, as in eczema epizooiica, where, in even 
slight cases, the vesicles will be found to extend underneath the coronary band. 



FOOT-EOT IN SHfeEP. 403 

ments to tlio coronary substance, or, where the attack has been 
violent, from the connecting laminte also, and thus the horny 
digits are more or less completely separated from the sensitive 
and vascular structures within ; and in a varying period, depend- 
ing on the severity of the attack, the claw can be pulled off with 
ease, or is cast off spontaneously, leaving the exposed living 
structures smooth, red, and congested, and now of course liable 
to be affected by external irritants, and to sprout up in the form 
of fungoid granulations, and thus may be confounded with foot- 
rot by inexperienced persons. Eeference to page 401 will show 
that even in the worst forms of foot-rot, where the horn is de- 
tached from the sensitive foot, that it still remains attached at 
its upper border. Now, in foot-and-mouth disease, the separa- 
tion always commences at the coronary junction. 

Professor Brown says — " Of the several quite distinct local 
diseases of the foot of the sheep, none is distinguished by 
the presence of a blister or vesicle in any part of the foot, 
while in the foot-and-mouth disease there are always vesicles 
present, or distinct evidence of their previous existence, and 
there is also a general absence of that condition of hoof which 
is usual in foot-rot. In exceptional cases the hoofs are elon- 
gated, much broken, and sometimes ragged and rotten; but this 
condition has nothing to do with the aphthous disease, which is 
indicated by the presence of vesicles between the claws, in the 
posterior part of the foot immediately above the hoof, and 
sometimes exactly on the portion of skin between the digits 
which covers the transverse ligament connecting the two sides 
of the foot together, and which is rendered tense, and therefore 
distinct when the digits are pulled apart. When the posterior 
part of the hoof is separated from the secreting membrane, as it 
often is in foot-and-mouth disease, the vascular surface is seen 
to be congested, but there are no signs of the so-called fungoid 
growths which distinguish foot-rot. In short, no two diseases 
can be more distinct from each other in the local appearances ; 
but independently of the evidence afforded by the diseased parts, 
there is in cases of foot-and-mouth disease clear evidence of 
febrile action in the system. The animal's appetite may not 
be much affected, nor is it necessary that the demeanour should 
be suggestive of much suffering, but the application of the 
thermometer will show a rise of internal temperature when the 



404 DISEASES OF THE FEET. 

animal is suffering from the aphthous affection. Making allow- 
ances for the variations of the temperature in sheep, ■which 
in health will range from 101° to 104°, the increase is quite 
marked, as the temperature in the diseased sheep will range from 
104° to 107°. It will not, however, in the majority of cases, be 
necessary to use the thermometer to decide the question of the 
nature of the disease, as the local evidence will be sufficient. 

" Vesicles in the mouth of the sheep, although not so generally 
present as in cattle, are very commonly found when they are 
looked for, but as the idea has long been prevalent that sheep 
are not affected in the mouth, it naturally has happened that 
the part has escaped notice, and besides, the lesion is not so 
prominent as in the mouths of cattle, and therefore not so readily 
recognised by the unpractised eye. In lambs of & few weeks 
old vesicles not larger than a hemp seed have been detected on 
the tongue. Abrasions on the lips and palate are frequently 
seen in sheep identical in character with those which are ob- 
served in cattle ; and altogether the evidence of the identity 
of the disease in cattle and sheep is perfectly conclusive, even 
irrespective of the admitted fact that the affection is inter- 
communicable in the two classes of animals." 

Professor Brown states that vesicles in the mouth are very 
commonly found when they are looked for. My experience 
leads me to a different conclusion, namely, that during some out- 
breaks they are as often absent as present, even in the earliest 
stage of the disease. 

In addition to the fever expressed by increased temperature, 
acceleration of the respiratory movements, sinking of the flank 
and belly — " clapping," as it is called in Scotland — and loss of 
appetite, which precedes and accompanies the earliest local 
manifestation of foot-and-mouth disease, another important 
difference exists, namely, the lameness of foot-rot very com- 
monly commences in one or two of the feet, and may or may 
not pass to the others ; whereas in foot-and-mouth disease all 
the feet may be simultaneously affected, in .which case the 
animal creeps in a very characteristic manner when first made 
to rise from the recumbent posture. In some instances all 
the feet may not be affected, or some may suffer more severely 
than others ; in whichever it is manifested, the lameness doe.«i 
not affect the feet consecutively as in foot-rot. 



FOOT-EOT IN SHEEP. 405 

Causes ofFoot-Bot. — ^Although it is ascertained that the tend- 
ency to foot-rot may he hereditary, and the progeny of some sheep 
of all hreeds are more liahle to it than others on the same farm, it 
must be confessed that the great cause of foot-rot is wet, causing 
softening of the horn. Where the grass is long and insinuates itself 
between the claws, the part of the upper and thin portion of the 
inner walls of the digits is the first to give way, and the disease 
may be said to be inter-digital, and is called the scald in some dis- 
tricts ; but where the grasses are short, mossy, and the soil sandy, 
the solar aspect of the foot is the first to suffer. Whichever 
way it is first manifested it is entirely due to wet soil, and in 
its prevention and cure this fact must be borne in mind. 

On hOI farms it is found that this disease appears almost in- 
variably about the end of July, and reaches its height towards 
the end of August and beginning of September. During this 
period the dews are heavy, and the grasses consequently satu- 
rated with moisture. 

Frevention. — " The prevention of foot-rot," says Mr. Armatage, 
" is a subject which should engage more attention than it has up 
to the present time." 

Of course it will be understood that removal from a wet to 
dry sound pasture is of pre-eminent importance, and from luxu- 
riant to a shorter kind of grass. In highly cultivated farms the 
removal of sheep from luxuriant pasturage is often a matter of im- 
possibility; when such is the case, experiments have been tried to 
harden the hoofs of the sheep, that they might resist the action of 
moisture, and some of these have been to some extent successful. 

The Messrs. Archibald of Overshiels, Glengelt, Duddingstone, 
&c., the celebrated breeders of blackface and Cheviots, inform me 
that they have found the following process superiorto all others: — 

A wooden trough of the following dimensions is to be made. 
Length nine feet, breadth two feet, and depth one foot and a 
half, with lid and lock, in order that it may be locked after it has 
been used. Into this trough a solution of arsenious acid of the 
following strength is to be poured, sufficiently deep to cover 
the feet of sheep as they are driven through it, namely, one 
pound of the arsenic to five gallons of water. 

Arsenic of itself is but slightly soluble in water, and in order to 
dissolve it readily, it is necessary to combine it with an equal quan- 
tity of an alkali, such as the common washing soda. The arsenic 



.4Q6 DISEASES OF THE FEET. 

and the alkali should be put in boiling water together, in a boiler 
large in proportion to the quantity of water it in to contain, and 
for the reason that the liquid is apt to rise suddenly; the carboiiic 
acid, combined with the alkali, is disengaged by the process of 
boiling, and during its escape causes rapid ebullition. For the same 
reason the water, after the addition of the powder, must be slowly 
boiled for some time, or until the arsenic is entirely dissolved. 

The sheep are to be driven through the trough containing 
the arsenical solution once a week ; if it is thought necessary to 
repeat it oftener, the liquid is to be weakened in strength by the 
addition of water. 

To prevent the sheep jumping out of the trough as they are 
being driven through, it it will be necessary to place hurdles at 
the sides; and it is important that it be borne in mind that the 
sheep be folded for a short time in a place where neither they 
nor any other animal can have a chance of grazing, or the conse- 
quences might prove disastrous. 

The Messrs. Archibald state that this, if applied about the 
middle of July, is not only the best preventative but the best cure 
of the disease, provided always that all loose and detached horn 
is carefully removed. 

There are a great many so-called specifics for foot-rot ; if looked 
into, however, they resolve themselves into caustics of various 
kinds. I have found the terchloride of antimony (butyr of anti- 
mony) as effectual, and much less painf ill to the animal, than any 
other caustic. If the fungoid growths be very prominent, it may be 
necessary to employ a strong acid ; in such a case nitric acid, care- 
fully and sparingly applied by means of a feather to the surface of 
the growths, may be used with advantage; where there are no 
fungoid growths, but merely a scalding between the claws, the 
tincture of the terchloride of iron diluted with an equal quantity 
of water is a very good application. In addition, I would sug- 
gest, that after the feet are dressed with any of the above-named 
remedies the exposed surfaces might be brushed over with a 
quick-drying varnish, or a solution of gutta-percha, in order to 
afford an artificial covering to the inflamed and irritable tissues. 
- ^hen the fungoid growths are not very large, a solution of 
sulphate of TOppey may be used, and the sheep driven slowly 
through ityur kept in it for a few minutes. 
^i ne^sis of the bones occurs, amputation, if confined to one 
yght be resorted to, in order to save a valuable ram or ewe. 



FZA-TEjy 






TUMOUES. 



EXPLANATION OF PHOTO-LITHOGRAPH, PLATE IV. 

1. Malignant Epulis.— Mouth of ox. The microscopic characters 
of this tumour are given at page 419. The cells, as will he seen by the 
microscopic drawing, Kg. 99, partake of the nature of epithelial cancer. 

2. Benign Epulis. — Mouth of sheep. Microscopically, the struc- 
ture of this tumour is fibrous. 

3. Epithelioma. — Tongue of ox. The true nature of the growths 
are not definitely made out. 

4. Medullary Cancer. — ^The tumour was originally roimdish in 
form ; distinctly separated from surrounding structures, and invested 
in a capsule of a semi-fibrous nature. The section shows various de- 
generative changes which have taken place within its substance. The 
tumour was removed by me from near the stifle-joint of a mare at 
Berwick-on-Tweed. It weighed four pounds, and, along with other 
masses of a similar character removed from the mammary gland and 
submaxillary space, made up an aggregate mass weighing 31 lbs. The 
mare died some time after the operation, and a post mortem examina- 
tion revealed many other cancerous tumours in various internal organs. 
The microscopic characters of this tumour are represented in woodcuts. 
Figs. 95, 96, and 97, page 418. 

6. Medullary Cancer of the Tail (not melanotic), showing the 
arrangement of its several masses ; on the left the tumour has ulcer- 
ated. Removed by me from a cab-horse ; no return of the disease. 

6. Medullary Cancer of the Bones op the Face of the Ox. — 
(1.) Large tumour. (2.) Cystic formation within the superior maxil- 
lary sinus. (3.) (4.) and (5.) Smaller medullary tumours. 

7. Osteo-Sarcoma of Ox. — The specimen having been boiled, the 
sarcous matter is removed, the bony trabeculse alone remaining. 

8. Cystic Growth in superior maxillary sinus of a year-old colt. 
(1.) The cyst. (2.) Fifth and sixth molar teeth uncut. (3.) Fourth 
molar on the point of " cutting." (4.) Worm-eaten fangs of tem- 
porary molars undergoing absorption. 

9. Dentigerous or Tooth Tumour, containing several hundred 
rudimentary teeth, fiUing the antrum (2.), and extending from it into 
the cavity of the mouth (1, 1). 

10. Large N^asal Polypus.— (1.) The tumour. (2.) Anterior naris. 



CHAPTER XXII. 

TUMOURS. 
CLASSIFICATION. 

TuMOUKS are included in that class of diseases named hyper- 
trophies or overgrowths ; and all their varieties consist in 
additions to the organised materials of the body, arising from an 
excess of formative force ; but in the case of each kind of tumour 
the mode is peculiar in which this excess is manifested. A 
tumour differs from an inflammatory exudate in — 1st. That its 
increase is of itself ; 2d. That it grows as a part of the body by 
its own inherent force, depending on the surrounding parts for 
little more than a supply of blood, from which it appropriates 
its nourishment ; Sd. As a general rule a tumour increases con- 
stantly, whereas an inflammatory exudation depends upon a 
morbid state of the parts at or contiguous to it; and in- 
creases in size only so long as the morbid action in the adjacent 
parts continues. Many tumours are solitary, but it very often 
happens that many tumours appear almost simultaneously, as 
in the case of verrucae or warts, in the same animal ; but such 
multiplicity of primary growths must be distinguished from 
metastatic formations, or those secondary tumours resultiiig 
from the transmission of the elements of an original tumour to 
other parts of the body characteristic of malignancy. 

Some tumours closely resemble the tissue on and in which 
they grow, and are consequently called homologous tumours; 
whilst others differ very materially from the surrounding tissue, 
and are called heterologous tumours. For example, a cartilaginous 
tumour growing from cartilage is homologous, but growing from 
any other tissue, as from a muscule or a gland, it is heterologous ; 
thus the same variety of tumour may be in one case homologous 
and in another heterologous. But heterology is not limited to 



CLASSIFICATION. 409 

the production of a tumour dissimilar in its structure from that 
in which it originated, but is applied to a growth dissimilar to 
that in which it is situated. Thus an excessive proliferation of 
epithelial cells within the ducts of the mammary gland is 
homologous, but when this becomes excessive, and extends 
beyond its normal limits, as seen in cancer, it becomes hetero- 
logous. 

A tumour rarely actually disappears, and thus differs from an 
inflammatory growth ; as a rule its permanence is in accordance 
with the tardiness of its growth. Green says that the more 
rapid the growth and the more lowly the organisation of the 
tissues formed, the sooner do retrogressive changes occur. The 
carcinomata and sarcomata generally develop rapidly, and consist 
for the most part of cells, which quickly degenerate. 

This cannot, however, be said of rapidly growing tumours in 
the lower animals. In melanotic sarcoma the growth is some- 
times very rapid, and shows but little or no tendency to 
degenerative changes ; but, particularly in lymphadenoma, it will 
be seen that a most rapid growth is associated with the entire 
absence of degenerative changes. 

Tumours usually develop from small beginnings. Some grow 
rapidly, others slowly and intermittently, and there is no limit 
to their growth, some reaching enormous dimensions. Their 
formation is always attended with more or less inconvenience 
and danger. The least injurious are those which grow slowly, 
and merely compress the surrounding tissues ; but a growing 
tumour requires to be fed, and the organs on which it may be 
placed in the system generally are deprived of some nutriment : 
if the growth be slow this may be unimportant, but if very 
rapid, the results may be very grave. The gravity and impor- 
tance of a tumour, benign in itself, are seriously increased by 
its situation. Thus a very small tumour, particularly if of rapid 
growth, in the brain or spinal canal may prove fatal to life ; 
and a tumour pressing upon the sesophagus or trachea, obstruct- 
ing the acts of deglutition and respiration, is a very different 
matter to a much larger, invading the skin, and interfering with 
no important function. 

A tumour is said to be malignant when it has a tendency to 
destroy and infiltrate into surrounding tissue, when it tends to 
recur after removal, and when it is metastatic and heterologous ; 



410 



TUMOURS. 



and benign, when its structure is not widely different from the 
natural tissue, or when it is not an infiltration displacing or over- 
whelming the original tissue of its seat ; neither does a benign 
tumour show a natural proneness to ulceration, or if it does ulcer- 
ate, the ulcer has a tendency to heal, which is not the case in a 
malignant tumour, where softening precedes an ulceration which 
has no tendency to heal — a morbid substance like the original 
forming the walls and boundaries of the ulcer — this substance 
passing through the same process of ulceration as the primary 
growth, and so the ulcer spreads and makes it way through all 
kinds of tissue. 

Tumours are now generally classified upon their histological 
characters, and are divided into two great groups, namely — \st, 
those composed of structures resembling the adult, and 2d, 
those composed of structures resembling the embryonic con- 
nective tissue types. The first group is made up of mesoblastic 
elements, and is arranged as follows : — 



1. — Ilistioid or Mesoblastic Tumours. 

(A.) Tumours typical of the fully developed connective 

tissues : — 



Type of fibrous tissue, < 
adipose tissue, 
mucous tissue, 
lymphatic tissue, 
cartilage, 
bone. 



Fibroma. 

Lipoma. 

Myxoma. 

Lymphoma. 

Enchondroma. 

Osteoma. 



(5.) Tumours typical of higher tissues : — 

Type of muscle, . . Myoma. 
„ nerve, . . Neuroma. 

„ blood-vessels, . Angioma. 

" P^P^"^ °^'^\^° °^ I Papilloma, 
mucous membrane, J ^ 

„ secreting glands, . Adenoma. 
(C) Sarcomatous tumours, composed more or less of embryonic 



CLASSIFICATION. 411 

or indifferent tissues, but in -which there may be — always abor- 
tive — some attempts at higher development : — 



Spindle-celled sarcoma, 



Small spindle-celled sarcoma. 

Large 

Osteoid sarcoma. 

Myeloid 



r Small round-celled sarcoma. 
Eound-celled sarcoma, . ■< Alveolar sarcoma. 

l Melanotic sarcoma. 

Parasitic sarcoma, . . Actino-mycosis. 



2. — Epiilielial Tumours, consisting not only of Mesohlastic, hut of 
Epiblastic and Hypohlastic elements in addition. 

On section these tumours are seen to consist of a dense basis 
membrane — cancer stroma — built of reticulated bands and tra- 
beculse, and containing within its areolae a substance of a softer 
and different consistence, often in the form of a milky juice — 
cancer juice. They are classified as the carcinomata, -which in- 
clude the four following varieties, namely — 1. Scirrhous; 2. 
Medullary or Encephaloid ; 3. Colloid ; and 4. Epithelioma. 

In addition to these t-wo great groups -we have cystic tumours, 
found in various parts of the body, due to the dilatation of ob- 
structed ducts, the embryonic forms of parasites, and to acci- 
dental causes, as seen in the endothelial cysts, found around 
tendons, serous abscesses, &c. 



CHAPTER XXIII. 

SIMPLE TUMOURS. 

FIBROMA OR FIBROUS TUMOUR — PAPILLOMA LIPOMA NEUROMA — 

ENOHONDROMA CRUSTA-PETROSA TUMOURS — PSAMMOMA — OSSE- 
OUS TUMOURS OSTEOMA PARASITIC CYSTS CYSTIC TUMOURS — 

TEETH TUMOURS SARCOMATA —MELANOSIS — ACTINO-MYCOSIS — 

CARCINOMATA HARD CANCER — SOFT CANCER — EPITHELIAL 

CANCER. 

I. — SIMPLE OE HISTIOID TUMOURS. 

The most common forms of tumour met with in veterinary 
practice are fibrous tissue tumours — Fibromata, and ordinary 
warts — Papilloma, fatty tumours — Lipoma, and cartilage 
tumours — Enchondroma. 

The fibroma, a fibrous tumour usually found in parts which 
contain much fibrous tissue, is slow in its growth, and is not 
accompanied by pain or tenderness, unless accidentally inflamed ; 
is of a hard, rounded form, with its surface smooth or divided 
into lobes ; generally moveable, and contained in a wall of 
areolar tissue. 

The most familiar example is the subcutaneous wart. These 
are of various sizes ; some as small as a pea, others as large 
as a goose's egg, lodged in the subcutaneous areolar tissue, 
singly or in clusters. They differ much in their degree of con- 
nection with surrounding parts, being sometimes firmly attached 
by continuity of tissue, at other times loosely imbedded in 
them, and easily moveable beneath the skin. Although many 
groups of several tumours in each may exist in the same 
structure or organ, it is very rare to see them co-existent in 
separate organs. They have very few vessels; indeed, some 
seem to have no blood-vessels, and no immediate communi- 
cation with the surrounding parts, but are lodged in a sac, 
and derive their nourishment by imbibing nutrient fluid from 
its walls. 



FIBROUS TDMOUKS. 413 

The tumours are composed of white fibrous tissue, blended 
with some yellow elastic fibres, closely resembling those of 
areolar tissue. These fibres vary in their different stages of 
development, and are interlaced together, forming very compact 
and solid masses. At first the tumours are quite unattached 
to the skin, but as they grow they burst through and become 
attached to it; and from their points of attachment prolonga- 
tions, in the form of fungoid granulations, rapidly grow from 
the surface. Their favourite seat is the subcutaneous areolar 
tissue of the inferior surface of the abdomen, where they are 
generally found associated with the epidermic wart. When the 
skin is cut through, it is often discovered that a large number 
of them, in a nest of condensed fibrous tissue, on which 
numerous blood-vessels ramify, are lodged in the areolar tissue 
of this part. They are then easily pressed out by the hand, 
and this is the best method of removing them, the sac being 
afterwards dressed with some astringent, such as a solution of 
sulphate of copper. They are also found in the uterus, more 
especially of the bitch, where they sometimes contain a fluid in 
their centre. 

Polypi belong to the fibrous tumoiirs, consisting of tissue 
similar to that of the last-named form. The tumour sketched 
in Photo-lithograph, Plate IV., is an example of a very large 
nasal polypus. 

A polypus may be defined to be a tumour attached by means 
of a narrow pedicle, and the most familiar example is the 
nasal polypus attached to the superior part of the nostril ; of a 
softish consistence ; bleeding when injured ; often containing 
a thin limpid fluid in its centre ; growing downwards, filling 
the cavity of the nostril, causing much uneasiness to the animal, 
and interfering very materially with the respiratory function. 

There is a discharge from the affected nostril, often tinged 
with blood, especially during exercise or work. The animal 
makes a snuffling sound in its breathing, and frequently sneezes. 
The tumour cannot always be seen, but by growth becomes 
visible to the examiner. Sometimes it grows in the contrary 
direction, falls into the isthmus faucis, and is apt to become 
temporarily lodged in the larynx, causing the animal to breathe 
with the greatest difflcultj^ with a loud roaring sound, and 
often to fall down from exhaustion and want of breath. By 



414 SIMPLE TUMOUES. 

great effort the animal coughs the obstructing tumour from the 
larynx into the fauces again, and all at once the roaring sound 
and difficulty of breathing disappear. Such cases are termed 
" Bellones " by horse-coupers. 

The only treatment for polypus is removal; and the best 
method is evulsion by the forceps. The instrument must be 
passed up alongside of the polypus to its roots, where they 
must be fixed by strong pressure on the handles ; and then the 
connections of the tumour must be torn by a compound move- 
ment of turning and pulling. I have removed them very 
successfully in this way. The nostril ought to be afterwards 
frequently syringed with an astringent wash, such as a solution 
of the tincture of the perchloride of iron. 

When the polypus grows into the fauces, it is quite possible 
to remove it — if it can be discovered by the hand — by enclosing 
its pedicle in a noose of strong wire, and tearing it away by 
strong and continuous traction. If it were possible to apply 
the " Ecraseur," the removal of this polypus would be rendered 
a very easy matter. Fibrous tumours, similar to polypi, are 
found in the ventricles of the brain. 

Pibrous tumours, especially in the horse, are often due to the 
imprisonment of pus in the deep-seated inter-muscular structures. 
For example, an apparently fibrous tumour, with well-defined 
borders, and no appearance of inflammation, is often found in the 
inferior cervical region, beneath the levator humeri muscle. It 
arises from the pressure of the collar, and when cut into, will 
be found to consist of the enormously thickened walls of an old 
abscess — small in itself, and containing a little pus. iigain, 
these tumours may be found upon those portions of the horse's 
sides that are liable to be bruised by the shaft of the cart. la- 
deed, with the exception of the subcutaneous tumours already 
described, the majority of the so-called fibrous tumours of the 
horse are due to the presence of pus too deeply seated to find 
its way to the surface. 

These old abscesses may be removed either by excision of 
the whole mass, or by destruction with caustics. If not very 
large, perhaps the latter is the quicker method; but if very 
large, the knife must have the preference. It is quite useless to 
attempt their reduction by the use of external stimulants, such 
as iodine or blisters. 



PAPILLOMATOUS TUMOUES. 



415 




n. — PAPILLOMATOUS TUMOUES 

Form a class of new formations of much interest, and are of 
frequent occurrence. Warts (verrucas) on the skin and on the 
mucous membranes are instances of them. Warts consist of a 

thickening of the epidermis, pro- 
duced by accumulation of its scales, 
with hypertrophy of the papillse of 
the true skin. 

These growths are found most 
commonly in young animals, their 
favourite seat being the under sur- 
face of the abdomen, the genitals, 
mammary glands, lips and eyelids. 
In the dog they are often seen in 
large numbers within the mouth, 
appearing in a very short space of 
time, and disappearing as quickly. 
When they form on mucous mem- 
branes, or when found about the 
o£l"pap?daTlTtt::„r4ti:d anus, they are called condylomata, 
condyloma, after the addition of They are of the same nature, but 

acetic acid. a. Vascular loop, in- ji. • • j. j.i. ii, 

temal to which is fibrous tissue, are Softer in consistence than the 

forming the axis of the papilla, wart. 

Outside are nuclei, b. b. Basement „i i 1 i ■ 

membrane, c. c. Epidermic cells. They may be removed by exci- 
250diam.— (Wbdl.) gion Or torsion ; twisting or pulling 

by the hand being very often sufficient. If they are found 
within the sheath of the penis, or on the prepuce surrounding 
the orifice of the urethra, the patient has to be cast, and the 
whole mass of them removed by the cautery or knife, and their 
seat cauterised. If this be not done, they are apt to grow again. 
Warts sometimes grow to an immense size, and hang like 
bunches of onions below the animal's belly ; when cut into, they 
are found not only to be warts, but also steatoma, or the subcuta- 
neous fibrous tumours already described. Indeed, when this 
kind of tumour breaks through the skin, it very closely resembles 
a common wart. They are found in horses and cattle, and most 
commonly in young animals. 

When in the mouth of the dog, they may be snipped off with a 
pair of scissors ; their removal in this way is not succeeded by 



416 SIMPLE TUMOURS. 

much hsemonhage, or the mouth may be washed twice or thrice 
a day with vinegar, which seems to have a wonderful effect in 
destroying them. When on the eyelid, their removal must be 
performed with great caution, or the animal may be damaged for 
life. Gentle and repeated touches with an acid, so as to destroy 
a thin pellicle at a time, is the best method for their removal 
when so situated. 

The "grapes" of chronic grease are similar to warts, con- 
sisting of thickened epidermis and of enlarged papillae and 
sebaceous follicles; they are best removed with the actual 
cautery ; shaved off, in fact, by a sharp-edged piece of iron 
heated to a red heat. 

Another kind of epithelial tumour is found in the vagina, 
especially of the bitch, larger than a wart, with a lobu- 

lated surface, and much vascu- 
larity, having a tendency to bleed. 
Several of these vegetations by con- 
fluence form a large tumour ; they are 
to be removed by being enclosed in 
a clam, and cut off by the cautery. 
They may be named as vascular epi- 
thelial tumours. 



Fig 81.— Fat cells, from turn- m. — FATTY TUMOUES OE LirOMATA, 
our removed from vagina of a 

ch^ch.^as^'dtS'^dfn Fe^er- Consist of normal fat cells packed to- 
marian for March 1872. 200 gether. They occasionally attain a very 
^^^ large size. When situated externally, 

they must be removed by excision, and the sac destroyed by a 
slight touch of the actual cautery or a caustic wash. Vaginal 
tumours sometimes consist of fat cells. The tumour from 
which the microscopic view is taken weighed 2 lbs. 5 oz., and 
was removed from the vagina of a cow by Mr. Cartwright of 
Whitchurch. 



IV. — NEUEOMATOUS TUMOUES. 

The term neuroma is applied to a fibrous tumour connected 
with the nerves. In the human being they are of frequent 
occurrence, several hundreds of them being found in one sub- 




NEUROMATOUS TUMOUES. 417 

ject ; but in the lower animals I know of only one set of nerves 
upon which they appear, and as the result of an operation, namely, 
upon the plantar nerves, after their division for foot lameness. 

These tumours appear within an indefinite period after the 
operation (neurotomy) ; in one case four years had elapsed 
before they began to form. They are of a solid firm consistence, 
composed of a fibrous stroma, the fibres of which have a wavy- 
outline, running parallel to or interlacing with one another, 
and having scattered throughout them numerous groups of cells 
more or less closely packed together. Eokitansky says — 
" These tumours lie between the fasciculi of the nerve, and are 
interwoven with their neurilemmatous sheath ; and it is a 
remarkable and no less important general rule, because of the 
symptoms which may result from its presence, or which may be 
set up by operations performed on it, that neuroma is never 
deposited in the centre of a nerve, but at its side, so that only a 
small part of its fascicuU is displaced. The displaced fasciculi 
are spread abroad and stretched over the tumour, while the 
greater mass of the nerve remains on the other side uninjured, 
and with its fibres in connection with one another." 

These tumours are found as rounded or oval bodies, with 
their long diameter along the course of the nerve ; varying in 
size, but never very large ; moveable in the transverse but not in 
the long direction. They are always on the superior division 
of the cut nerve. They sometimes cause great pain, manifested 
more particularly when the horse is standing still. He will 
then often lift his foot from the ground, as if the pain were 
lancinating; but the lameness is not so evident when he is 
made to move. When the tumour is pressed upon, or handled 
in any way, the patient evinces acute agony. Sometimes, how- 
ever, these tumours, although of some magnitude, cause no in- 
convenience ; but they are apt to be struck by the opposite foot, 
and so cause the animal almost to fall to the ground. They 
sometimes make their appearance in a short time after the 
operation of neurotomy, and are the result of a badly performed 
operation; the operator having divided the nerve below the 
upper angle of the wound in the skin, thus leaving a portion 
of it in the wound, which, becoihing embraced in the reparative 
material, forms a nucleus for the growth of the neuroma. 
The only treatment is excision by the knife. 

2 E 



418 



SIMPLE TUMOUES. 



V. — CARTILAGINOUS TUMOUES, OE ENCHONDEOMATA. 

These may take place in the soft parts, or in bone; their 
favourite seat being the region of the sternum, or upon the ribs. 
They are frequently caused by external injury. There are two 
forms of them; one being round or oval, with well-defined 
borders, and the other having no well-defined limits, but resem- 
bling an infiltration into the surrounding structures. In the 
latter case it will generally be found that the tumour arises from 
the development and growth of carti- 
lage in an inflammatory exudate ; and 
wounds involving the sternum are very 
apt to be accompanied by this compli- 
cation. 

To the touch these tumours are hard 
and dense, but present a slight elasticity. 
They gradually increase in size, and 
when on the sternum become a source 
of hindrance to the animal's movements, 
causing him to move with the fore legs 
wide apart, and with apparent stiffness 
in the gait. The skin over the en- 
largement soon becomes raw by the 
friction of the elbow on its surface. 




The rounded form of tumour gene- 



Tig. 82. — Proliferation of 
diseased cartilage. Large 

groups of cartilage cells within 
a common envelope (wrongly 
called parent cells), produced 
from single cells by successive 
subdivisions. At the edge one 
of these groups has been cut 
through, and in it is seen a, 
cartilage cell invested by a, 
number of capsular layers (ex- 
ternal secreted masses), 300 
diam.— (VinOHOw. ) 



rally appears on the cariniform cartilage 
as a globular enlargement, hard and 
firm to the touch, causing little or no 
inconvenience to the animal, unless 
interfered with by the collar. 

I am not aware that these tumours grow within the shell of 
a bone, as in the human being, but on the outside, and gene- 
rally fastened to the bony wall and invested by the periosteum, 
which is greatly thickened and overgrown. When cut with the 
knife, they present a bright, greyish, translucent, or pinky-white 
appearance, and sometimes coarsely granular, or opaque, with 
gritty points, as if gradually ossifying. When examined micro- 
scopically, they are found to consist of cartilage cells, mixed with 
fibres of white fibrous tissue. The fibres are very delicate and 
tufted, and contain the cartilage cells, either singly or in groups. 



CRUSTA-PETROSA TUMOURS. 



419 



The only change that occurs in these tumours is their ossifica- 
tion into a cancellous structure enclosed in a thin compact shell 
of bone. I have never seen the fatty degeneration or cystic 
transformation spoken of by human pathologists ; but it is quite 
possible that such a change may occur. 





Fig. 83. 



Pig. 84. 



ViGS. 83 and 84. — Enehondroma. Fia. 83. Structure of a firm enohondroma. 
The right of the figure represents, above, mineral deposit in and around the cells ; 
and, below, some isolated cartilage corpuscles. Pig. 84. The same, after the 
addition of acetic acid, rendering the whole — and especially the nucleus — more 
transparent. 250 diam. — (Bennett.) 

Treatment. — The only method is their removal by excision, 
and that as early as possible. 



VI. — CRUSTA-PETEOSA TUMOURS. 

The following drawing represents a section of a tumour now in 
the Veterinary College Museum, composed of crusta-petrosa, 
attached to one of the molars of the ox. I have no history of 
the case ; but upon examination find that the attached tooth is 
the last molar of the upper jaw. 

At A. the tooth is represented with its table running obliquely 
downwards towards C, and its crown lost in the adventitious 
substance. B. The shining surface of the section, and G. the 
crown surface of the tumour, slightly worn upon its inferior 
aspect by contact with the teeth of the opposing jaw. The 
tumour weighs 1 lb. 3 oz. 

Tomes describes a similar condition of the crusta-petrosa under 
the term dental exostosis or hypertrophy of the cementum, and 
he says — " It will not be forgotten that the surfaces of the fangs 
of teeth are coated with a thin layer of cementum. Under 
certain circumstances this layer becomes increased in thickness 
by additions on the external surface. The newly added cemen- 



420 



SIMPLE TUMOURS. 



turn is in every way similar in structure to that previously form- 
ing part of the tooth." He again says — "In dental exostosis, 




Tra. 85. 

the amount of new cementum may be very slight, or may be 
considerable in quantity. The affected fang may be but little 
enlarged, or it may be increased to twice its natural size. Near 
about the end of the fang is the most common situation to find 
the greatest amount of cementum ; but you seldom find an 
increase on one side of the fang only, unless the opposite side 
has been exposed by the absorption of the giim, or deprived ■ of 
its periosteal covering. In some cases nodules of cementum are 
found in various parts of the fang, even near the neck of the 
tooth." And he • concludes that " dental exostosis is caused by 
that condition of the periosteum which is called irritation — a 
state usually induced by pre-existing disease in other dental 
tissues, and in a great majority of cases by caries — not always, 
however." — (Dental Physiology and Surgery, by John Tomes, 
Surgeon-Dentist to the Middlesex Hospital.) 



VII. — CALCAEEOUS TUMOURS — PSAMMOMA. 

These consist of a deposit of calcareous salts in various parts of 
the body — in the testicle, parenchyma of organs, and upon nerves. 

Psammoma often constitutes those tumours found within the 
folds of the lateral ventricles of the brain of the horse, and is 
important when sufficiently large to induce symptoms of brain 
pressure. 



OSSEOUS TUMOURS — OSTEOID TUMOUES. 421 

Vm. — OSSEOUS TUMOURS AND OSTEOPHYTES 

Are very irregular, of a warty stalactio shape, and are common 
in the neighbourhood of joints where the articular surface is 
affected with caries, and sometimes surround the tendons of a 
limb when no joint disease is present. — (See Photo-lithograph, 
Plate I., Fig. 4.) 

They result from the ossification of an exudate which has 
been formed in consequence of some cause of inflammation. 
Osseous tumours are of a more compact structure than osteo- 
phytes, and grow more from the compact structure of the bone 
itself. Cases of great lameness sometimes occur from these new 
formations becoming inflamed from accidental causes, and T 
have seen necrosis of them produce sloughing of the skin, and 
the formation of sinuses. 

IX. — OSTEOID TUMOUES — OSTEOMA. 

(See Photo-lithograph, Plate I., Fig. 9.) 

These are tumours of irregularly protuberant surface, affect- 
ing both the upper and lower jaws of horned cattle. They are 
generally of a slow, but sometimes of a rapid growth, and 
when so, they possess some malignity (see Ostea-Sarcoma.) They 
consist of a cancellous bony tissue, forming trabeculse, which sur- 
round spaces filled with a greyish white, vascular, fibrous material, 
in which a varying quantity of cells and nuclei are imbedded. 

These tumours may vary in their density, from the presence 
of more or less bony structure in their formation. 

The origin of osteoma is very obscure, but it seems to depend 
sometimes upon the tubercular diathesis, as upon dissection the 
various structures adjoining the tumour are usually found matted 
together, and firmly adherent to it, whUst spots of tubercular 
matter may be found here and there scattered throughout its 
substance. 

The only treatment that can be recommended is the removal 
of the tumour at its very earliest stage, and before it has 
attained any size. If it be of any magnitude no treatment 
should be attempted, but the animal ought to be fed for 
slaughter, if not already fit. These tumours do not seem to 
cause much pain or inconvenience for a long time, and hence 
the animal will feed well enough. 



422 SIMPLE TUMOURS. 



X.— PAEASITIO CYSTS. 

The compound cysts include the hydatid larval conditions of 
many parasites, such as — 

Gysticercus hovis — in the muscles of horned cattle. 
„ cellulosce — muscles of the pig. 

„ pisiformis — entrails of hares, &c. 

„ cucumerinus — body of dog louse. 

„ tenuicollis — liver, walls of mesentery, pleura, 

pericardium, diaphragm, &c. of sheep and 
pigs. 
„ fasciolaris — liver of rat and mouse. 

Ucchinococcus mterinorum — large bladder-worms in liver, 

heart, lungs, &c. 
Gcenurus cereh'olis — in brain of herbivora, particularly sheep. 

Of these, however, the Gcenurus cerehralis and the Hcchincocci 
are the only ones which attain any size. 



XI. — CYSTIC TUMOUES. 

These tumours are divided hy Paget into simple or barren, 
and compound or proliferous, the former containing inorganised 
matter or fluid, the latter various organised bodies. 

The barren cysts contain a fluid-like serum, such as that 
found in serous abscesses (capped elbow and capped hock), or 
synovia-Uke fluid, as in the enlarged hursse (wind-galls) ; whilst 
others contain a more highly organised fluid, as in ranula. 

These cysts, according to the same authority, have at least 
three modes of origin. 1st. Some are formed by the enlarge- 
ment and fusion of the spaces or areolae of the connective or 
other tissues. In these spaces fluids accumulate ; the tissues 
become rarefied, and gradually the boundaries of the spaces are 
levelled down and walled in, tiU a perfect sac or cyst is formed, 
the walls of which continue to secrete. 

2d. Some cysts are formed by dilatation and growth of natural 
ducts or sacculi, as are those sebaceous or epidermal cysts, 
which, formed by hair follicles, have permanent openings. Such 



CYSTIC TUMOURS. 423 

are also certain cysts containing milk that are formed of enlarged 
lactiferous tubes, such as the ovarian cysts, formed by the over- 
grown Graafian vesicles; and such appear to be certain cysts 
formed of dilated portions of blood-vessels shut off from the main 
streams. 

3d. Many, and perhaps the great majority of cysts, such as 
those of the kidney, the choroid plexuses, the chorion, and the 
thyroid gland, are formed by the enormous growth of new ele- 
mentary structures, having the character of cells or nuclei, which 
pursue a morbid course from their origin, or from a very early 
period of tlieir development. 

Simple or barren cysts, as they occur in veterinary practice, 
may be divided into gaseous, serous, synovial, and mucous. 

Gaseous cysts have been observed by Hunter on the intes- 
tines of pigs. I have frequently seen them on the intestines 
of dogs. A cyst of this kind often forms on the hind quarters 
of horses, in the region of the trochanter major of the femur, 
which does not seem to contain any fluid when cut into, and 
upon dissection presents a mere cavity, lined by a glistening grey 
membrane. It can be distinctly observed in the living animal 
Can the term wind-gall, as applied to distended synovial bursa, 
have arisen from the fact that this cyst seemingly contained 
nothing but air ? 

Serous cysts arise in two ways: — 1st. From the effects of 
pressure ; and 2d., without evident cause. To the first belong 
capped hock, capped elbow, and other so-called serous abscesses. 

Serous abscesses are soft tumours, formed by an effusion of serum 
into the areolse of the connective tissue of the part, which be- 
comes condensed, and marks out the limits of the cyst. Within 
the cyst the fibrous trabeculse, or bands of connective tissue, are 
gradually absorbed, and give place to the effusion, until at last 
a cavity is formed, which is filled with serum, and lined by a 
more or less perfect epithelium. In some serous abscesses, more 
particularly if caused by great pressure or friction, inflammatory 
products are formed, which become consolidated; or a per- 
fectly formed cyst may inflame, and become converted into a 
solid tumour. In others again, the areolar structure is not so 
completely removed, and the serosity will be found in various 
alveoli or spaces, giving to the tumour a honeycomb appearance 
when cut into. 



424 SIMPLE TUMOUBS. 

Wlien on the elbow, the best treatment is the reduction of 
tlie tumour by puncture ; the cavity afterwards injected with a 
solution of sulphate of zinc, or of iodine, and the orifice of 
puncture kept open until the cavity of the cyst has beaQme 
obliterated. Another plan is to excite the suppurative actioiN 
in it after it has been punctured, by injecting a stimulating 
mixture, as ammonia and oil, or by inserting a seton through 
its centre. It is useless to puncture and allow the wound to 
close immediately, for the walls of the sac have acquired 
secreting properties, and continue to pour out the serosity, which 
will speedily fill the cavity of the cyst. It is therefore necessary 
to keep the puncture open imtil the walls of the sac have be- 
come adherent to each other, and its cavity destroyed. 

When the cyst has become consolidated by the causes already 
given, it will often be found that a little suppuration occurs in 
the centre of the tumour ; but it is never very extensive, and 
the suppxirative spot is surrounded by a thick wall of condensed 
fibrous tissue of a greyish appearance. 

There are two ways of removing the tumour when in this 
condition — by excision, and by sloughing it with escharotics. 
I have tried both plans, and prefer the latter, provided it is 
carefully done. I puncture the tumour in two or three places, 
and insert into each puncture a very small quantity of finely 
powdered corrosive sublimate and arsenic, in equal parts, rolled 
up in a small piece of tissue paper. The effect of this is two- 
fold: — (1st.) It destroys the vitality of the tissue which it 
bouches; and (2d.) Excites absorption throughout the whole 
extent of the tumour. The absorption first excited in the living 
structures in immediate contact with those destroyed by the 
agent, whereby a line of demarcation is formed between the 
living and dead tissue, becomes general throughout the tumour, 
and in a few days it will be seen that it has diminishediju- 
volume in every direction. After the sloughs cause^-'^^e 
escharotics have been removed, the parts should be kept clean 
for a few days, at the end of which it may be necessary to reapply 
the caustic. 

If excision with the knife be preferred, the operator must 
make his incision in the perpendicular direction only, as a 
crucial incision leaves an ugly blemish. Two incisions parallel 
to each other may be required in very large tumours, and about 



CYSTIC TUMOUES, 425 

an inct apart, in order to remove a portion of the skin, which, 
if left, would be an ugly blemish. 

Ca,pped elbow is caused by the animal lying upon the heels 
of his shoe, and is apt to be produced by a shoe too long in the 
heels. It must therefore be remembered that the application 
of proper shoes is the first step in the treatment, and, in addi- 
tion, that a pad or bandage should be placed around the foot, 
in order to prevent any chance of bruising during the period 
of treatment, and for some time after recovery. Some horses 
will cap their elbows, no matter how carefully they are shod, 
and these, whilst in the stable, should always have a boot 
or pad to cover the heels of the shoe and posterior parts of 
the foot. 

The treatment for capped hock is a more difficult matter, for 
unless great care be taken, a small enlargement on the point of 
the OS calcis — of a soft pliable nature — may become converted 
into a hard, solid, and unsightly swelling, which will lessen the 
value of the animal to a very great extent. 

Serous capped hocks are most frequently seen in well-bred 
horses, whilst capped elbows prevail amongst those of a coarser 
breed. ^Not that there is any special predisposition in either 
class of animal, but from the facts that coarse horses are shod 
with turned-up or long heels, and that the weU-bred ones are 
liable to accidents to the points of the hocks from kicking in 
harness or in the stable, being, as a rule, more restless at night 
than the coarser-bred horse. 

Some horses have a habit of scraping all their bedding from 
under them, and of lying upon the bare floor of the stall. Such 
are very frequently seen with the points of their hocks enlarged. 
I always look with suspicion upon horses with this blemish, as 
generally it is indicative of some vice. 

If the enlargement is not very unsightly, it should be left 
alone- if there is any heat of skin and inflammation, the appli- 
cation of cold to the part and the administration of a purgative 
will constitute the best treatment. But if the sac be large and 
the hock unsightly, the insertion of a seton through it, not 
merely between it and the sldn, will occasionally reduce it. 
There is no danger in this, for there is no synovial cavity 
interfered with in any way. The seton should remain in for 
a fortnight, but no longer, as it is apt, if kept in too long, to 



426 SIMPLE TUMOUES. 

produce considerable tliickening of the subcutaneous tissues of 
the parts surrounding its course. The cyst sometimes becomes 
consolidated, either from the treatment employed for its removal, 
or from some other cause. The repeated application of iodine, 
or its combination with mercury, wiU often reduce it very con- 
siderably. In some cases a strong application, such as one dram 
of the biniodide of mercury to the ounce of lard, will answer ; 
in others, a frequent application of a milder preparation will 
do best. I have found the following a very nice remedy: — 
Hydrargyrum biniod., one drachm; water, twelve ounces; and a 
sufficient quantity of the iodide of potassium to dissolve the 
biniodide. This is to be applied once or twice a day until 
slight soreness is produced, and reapplied when the soreness 
disappears. If possible, the horse should be turned out to grass, 
or kept in a thickly bedded box during treatment. 

Cysts upon the hock or elbow, or indeed upon any part of 
the body, if they do not cause lameness, are not to be looked 
upon as unsoundness. 

A form of capped hock arising from disease of the os calcis, 
and an unsoundness, has been already described (page 312). 

In some rare instances collections of fluid-forming cysts occur 
in front of the patella, the knees, and other parts of the body. 
They may be opened with safety. 

In horned cattle immense cysts form in front of the knees, 
caused by the animal being compelled to lie upon a hard floor. 
A seton through their substance, and the application of a bandage, 
to prevent bruising whilst the patient is lying down, will gene- 
rally remove them. 

Serous cysts form in the ovaries, mammary glands of bitches, 
in the thyroid body of all our patients, and in the facial sinuses 
of the horse and ox. 

The cystic growths which are found in the ovaries are either 
simple or unilocular, compound or multilocular ; sometimes 
scarcely increasing the normal size of the ovary, which is found 
to have lost its natural structure, and its place taken up by a 
number of small cysts ; they are supposed to result from dis- 
tention of the Graafian vesicles by a morbid increase of their 
contents. In other cases the cystic growths attain an immense 
size, and hold a large quantity of fluid, which distends the 
cavity of the abdomen, and presents a swelling externally which 



CYSTIC TUMOURS. 427 

fluctuates on pressure. This form of dropsy is common in 
bitches. The treatment is by tapping (paracentesis), and after- 
wards injecting the tincture of iodine through the canula. I 
have repeatedly performed this operation with success. I gene- 
rally introduce the trocar as near the base of the tumour as 
possible, and send it upwards obliquely through the skin and 
subcutaneous tissues. The limits of the tumour in bitches 
may be very well defined by a careful external manipulation. 

In the cow small ovarian cysts are sometimes a cause of nym- 
phomania. Their presence can be detected by an examination 
per rectum, which must be thoroughly emptied, and the hand, 
being introduced into it, is passed over the uterus until it reaches 
the ovaries. The diseased ovary is larger than the healthy one, 
is irregular and lumpy on its surface, and more or less elastic. 
Moderate compression wiU cause rupture of the cysts. On the 
following day there may be increased excitement, with trifling 
fever; but with quiet and a light diet these soon disappear. 
Goetz avers that tubercular masses in the ovaries may be dis- 
pelled in the same manner. — ( Veterinary Journal^ 

Ovarian dropsy has also been seen in the cow and in the 
mare. 

Cysts in connection with mucous membranes and glands are 
termed " mucous cysts," and may be witnessed occasionally in 
the mouths and on the lips, as well as in the vicinity of the 
eyes, of the lower animals. I have seen that form called ranula, 
which is a sac containing a glairy fluid, situated under the 
tongue, on either side of the fraenum. It impedes the move- 
ments of the tongue, and causes the patient to froth at the 
mouth. It requires to be removed by a pair of scissors, and the 
cavity touched with caustic. Pointer and setter dogs are subject 
to ranula. 

Cysts in the thyroid body constitute bronchocele ; they are 
said to be caused by the water which the animals drink, and 
that if the water be changed they will disappear. But I have 
some doubt as to the truth of the statement that bronchocele 
is solely caused by the presence of magnesian lime in the water, 
as I have seen weU-marked cases in young foals, and in large 
flocks of lambs, where this could not possibly be the cause. 
Doubtless it is found most abundantly on the magnesian lime- 
stone formations ; but it cannot be denied that low situations. 



.428 SIMPLE TUMOUKS. 

or a damp atmosphere upon elevated situations, will act as causes 
of bronchocele. 

It is detected ty a soft fluctuating swelling of the thyroid 
body, occupying one or both sides of the larynx. Treatment : 
Eemoval of apparent causes, with good food, warm shelter, and 
the administration of iodine or its salts. If these are not suc- 
cessful, and if the swelling interfere with the usefulness or value 
of the patients, paracentesis must be perlbrmed, and the sacs 
afterwards injected with tincture of iodine. 

Of the compound or proliferous cysts we have examples in 
cysts bearing cysts, constituting the compound serous cysts of 
the ovaries, thyroid body, and mammary gland ; in cutaneous 
proliferous cysts, or cysts bearing hair and skin ; and in denti- 
gerous or teeth-bearing cysts. 

Of the cutaneous cysts we have many examples from the 
horse, cow, and dog. Hair-bearing cysts have been found in 
parts far removed from the outer surface of the body, as in the 
brain and ovaries. 

Mr. Paget says, that " it is perhaps only during the vigour of 
the formative forces in the foetal or earliest extra-uterine periods 
of life that cysts thus highly organized and productive are ever 
formed. The sebaceous, epidermal, or cuticular cysts that grow in 
later life are imperfect, impotent imitations of these, yet clearly 
are the same disease, and are therefore most naturally classed 
with the proliferous cysts, needing only to be named according 
to their contents." 

The truth of the above quotation must be apparent to all who 
have seen cases of this kind, for they are generally found in 
very young animals as small hard tumours, some of them having 
a very small aperture through which some of their contents can 
be pressed out, whilst the majority of them are without any 
aperture whatever. When cut into, they are found to contain hair, 
along with sebaceous matter, forming a globular and hardened 
mass, enclosed in a cyst with a laminated pliable wall, lined with 
epidermis and covered with hair. 

The most important compound cystic diseases that come under 
the notice of the veterinarian, are — 1st. That where multiple 
cysts, or 2d., dentigerous cystic growths, invade the superior 
maxillary sinuses. (Photo-lithograph, Plate II., Fig. 8, is an 
illustration of the former, and Fig. 9 of the latter.) 



CYSTIC TUMOURS. 429 

The first form is found in animals during tlie active period 
of dentition — from one to three years old — and is recognised 
by a gradual enlargement of one or both sides of, the face, 
usually of one side only, with a discharge from the nostrU of 
an albuminous fluid of the consistence of synovia, which 
gradually changes into a purulent matter streaked with blood. 
There is a snuffling sound in the breathing, as if the nasal 
cavity were diminished in calibre; and this, as well as the 
swelling and discharge, increases — sometimes very rapidly, at 
other time more slowly, until at last the animal has to be 
destroyed. 

There is no cough, or if there be, it is only accidental, and 
the animal usually feeds well and thrives moderately. 

On making a post-mortem examination the superior maxUlary 
sinus will be found to contain a rounded mass (made up of 
numerous cells, containing a glairy fluid), pressing upon the 
nasal borders and turbinated bones, causing them to bulge into 
the nasal cavity, diminishing its calibre, producing a difficulty in 
breathing, and a snuffling sound during the egress and ingress of 
the air. 

Upon trephining a case of this kind, it wUl be discovered that 
the sinus contains a glairy fluid, and a friable and highly vascu- 
lar mass, which forms the walls of the cysts, having a structure 
similar to that of the turbinated bones. "Whether it is an extra- 
ordinary development of the sinus before the bones of the face 
are sufficiently large to accommodate it, or whether it is a new 
formation — a cyst — I can scarcely determine ; but whatever it 
may be, it can be removed by an operation if it has not been 
■"Ilowed to go on too long. The method of operation is as fol- 
lows : — Make an incision through the skin about four inches 
long, and dissect it upwards as a flap ; trephine the face, near 
the junction of the nasal and superior maxillaiy bones of the side 
affected, in two places, about' three inches apart ; and with the 
bone forceps remove the bone between the two apertures, making 
the gap about an inch in width, then with a hook and sharp 
scalpel dissect the whole of the sac away, taking care not to 
disturb the young teeth. If it be found that the turbinated 
bones have been pressed into the nasal cavity, a portion of them 
may be removed also. After washing out the Mbris of the sac 
and clots of blood, bring the ski]-, to its proper position, and 



430 SIMPLE TUMOURS. 

secure it by metallic suture. When the wound is healed, it wUl 
be found that the discharge from the nose and the difficulty in 
breathing have disappeared, and that the life of a valuable young 
animal has been saved. 



DENTIGEROUS CYSTS OE TEETH TUMOURS. 

Cysts containing teeth have been found in the testicles and 
other parts of the body ; but the teeth-bearing cysts, which are 
of importance to practical men, are those immense collections of 
imperfect teeth-forming tumours within the antrum, as shown 
in Photo-lithograph, Plate II., Fig. 9. I have met several cases 
of this kind, and have extracted teeth from even so high as the 
base of the ear. 

During hfe, these tumours are distinguishable by more or less 
disfigurement of the face, by a bulging outwards of the superior 
maxillary bone, accompanied in some cases by amaurosis of one 
eye, succeeded by atrophy of the eye from the pressure of the 
growing tumour. In other cases, these complications are not 
present, but now and then an abscess forms in the post-orbital 
region, which will be found upon examination to contain a hard 
body — an imperfect tooth. 

To understand the process by which these " teeth tumours " 
are formed, it will be necessary to remember that the teeth of 
all animals belong to and arise from the membraneous portion 
of the digestive canal, and that at a very early period of foetal 
life a provision is made for the development of the permanent 
teeth, as well as for that of the temporary ones. This provi- 
sion, according to Goodsir, who devoted much attention to the 
subject, is as follows: — As early as the sixth week of intra- 
uteral life (in the human foetus) a groove appears along the 
border of the future jaws, called the primitive dental groove, 
which is lined by the membrane of the mouth. At the bottom 
of this groove projections — papillae — spring up, corresponding 
in number with the temporary teeth ; these gradually increase in 
size, and acquire the shape of the future teeth. 

Whilst the growth of the papiUse is going on, partitions are 
formed across the groove, by which they become separated 
from each other. These partitions subsequently form the bony 
sockets. 



TEETH TUMOUKS. 



431 



The formation of these partitions places each papilla in a 
separate cavity ; and concurrent with this process, small growths 
take place upon the membrane of the mouth just as it dips 
into the papillary cavity or follicle, which finally, by union 
with other growths, form a lid which covers the papillee in a 
closed sac or bag. 

Before the final closing of the follicle, a slight folding inwards 
of its lining membrane takes place. 

This folding inwards of the membrane of the primitive groove 
is for the purpose of forming a new cavity — the, cavity of reserve 
— which furnishes a delicate mucous membrane for the future 
formation of the permanent teeth. By consulting the diagram 
the reader will better understand this process. Fig. 1 shows the 




Fig. 86. 



papilla standing in the groove, and a slight folding inwards of 
the membrane of the primitive groove near to the lid on the 
right side. Fig. 2 makes this more apparent ; and in the other 
Figs, we find the folded membrane considerably altered in form, 
and increased in size, having a projection from its bottom part, 

the papilla destined for the production of the permanent tooth 

detached from its follicle.— (From Simonds On the Age of the Ox, 
&c., 1854) 

From a study of this, it will be found that the cavity in 
which the permanent tooth is developed is a mere detachment 
from the lining of the primitive groove, by the formation of a 



432 



SIMPLE TUMOUES. 



fold in the lining membrane, and that in this cavity a papilla 
is formed exactly in the same way as in that of a temporary 
tooth. ISTow, I look upon the formation of these dental tumours 
as being due to some eccentricity in this folding of the lining 
membrane, by which the cavity of reserve is made up of several 
folds ; that these folds become eventually separated from each 
other, forming separate cavities of reserve ; and that a papilla 
becomes developed in each cavity thus formed in a manner 
similar to those constituting the papillffi of the natural teeth. 
These irregular papillae become finally converted into irregular 
teeth, which, for want of space in the mouth, are forced upwards 
into the antrum, and — as in the photo-lithograph — may com- 
pletely block it up, as well as the posterior nasal opening. I 
have classified them as cystic tumours, as, in the first instance 




Fig. 87 and Diagram, showing supposed development of dentigerous tumour 
A, Eccentric folding of "cavity of reserve," 3 and 4 showing its two extremities 
2, the gum. B, Further development of tooth, and of the eccentric folding of the 
reserve cavity, the folds becoming separated from each other, each fold forming a 
separate cavity. 0, shows two real teeth removed from a tumour imperfectly 
united, each tooth having a pulp cavity. 

they are enclosed in sacs or cysts; they, however, soon burst 
through their investing membrane, and form a large tumour, 
composed entirely of teeth, having a great variety of shapes, and 
running in different directions. The teeth vary in size, some 
being very small, others nearly as large as a permanent molar ; 
each tooth has a pulp cavity, and is composed of the same 
structures as the natural teeth. 

Should their removal be determined upon, it will be necessary 
to trephine the superior maxillary sinus, and detach them with 
the forceps. 



THE SAECOMATA. 



433 



THE SAECOMATA. 

As already stated, the sarcoma are tumours built up on the 
type of embryonic connective tissue, and in which, as in 
embryonic life, the cellular elements predominate over the in- 
tercellular substance. The sarcoma are by far the most common 
forms of malignant tumours met with in veterinary practice, 
particularly in the horse, although all the ordinary patients of 
the veterinarian are subject to their inroads. 

They vary in consistence from hardish nodulated masses, as 
in lympho-sarcoma, to those of a soft colloid character, resem- 
bling embryonic tissue in its most immature — gelatinous — stage, 
and when it consists almost entirely of small round cells and a 
soft amorphous intercellular substance. There is generally, 
however, an attempt at the formation of some higher kind of 
connective tissue, and consequently there are varieties of these 
tumours, but that most commonly — nay, almost invariably — 
seen in horses and cattle is the small round-celled sarcoma, 
which are very soft and rapidly growing tumours, and chiefly 




Fig. 88. — Sarcomatous cells, with a few fibres. 
!From the dog. 

occur primarily in fasciae, loose subcutaneous tissues, in the 
connective tissue of the nerve centres, frequently in the retina, 

2e 



434 SIMPLE TUMOUKS. 

constituting fungus hsematodes ; from the periosteum ; and in 
man from the medullary tissue of bones; and, secondarily, 
these growths invade the lungs, and afterwards affect the 
more vascular organs, in which there is a complex capillary 
network. 

When cut into, they are of a uniform soft, brain-like con- 
sistence, of a reddish white or grey colour, somewhat translucent 
or opaque, very vascular, the blood-vessels being often dilated, 
varicose, and liable to rupture, which gives rise to ecchymoses, 
the formation of blood cysts, and, if the skin be broken, to 
haemorrhage. On scraping the cut surface, a thickish juice, rich 
in cells, is obtained, and on this account, as well as their other 
clinical characters, they have been confounded with medullary 
cancer, from which they are distinguished by the absence of 
alveolee and stroma, and by the uniformity of the character of 
their cells. 

The other tumours belonging to this group, glioma, growing 
from the connective tissue of the brain, spinal cord, and nerves, 
are large round-celled sarcoma, which specially affect the mucous 
tissue of the pharynx and posterior nerves, where it forms a 
firm, almost fibrous, pale polypoid growth. 

Spindle-celled Sarcoma. — In this tumour there is an attempt 
at the formation of a higher type of connective tissue than in 
the round-celled varieties. They approach the fibroma to some 
extent, but are slightly malignant ; the intercellular substance 
is sometimes very scanty, or almost imperceptible, whilst in 
other cases it is more abundant ; the cells, however, are elon- 
gated, and throw out spindles of varying length. Both large 
and small spindle-celled sarcoma rarely give rise to secondary 
growths, and are generally surrounded by a more or less definite 
capsule; are firm, solid, or elastic, and present a pale fleshy- 
looking surface on section. 

The Myeloid Sarcoma. — This is a spindle-ceUed sarcoma, 
consisting of small spindle cells with the addition of the large 
many nucleated cells, termed myeloid cells, and the tumour 
generally grows in connection with bone, particularly with the 
jaws, constituting one of the terms of what is familiarly known 
as osteo-sarcoma, commonly seen in the ox. They generally cal- 
cify, and are considered the least malignant of all the sarcomata. 

It may here be stated that, with the exception of the small 



MELANOSIS, OR MELANOTIC SARCOMA. 435 

round-celled sarcoma, the other forms already mentioned pre- 
sent very little interest to the practical veterinarian, as they 
are rarely met with amongst his patients. The only case of 
pure spindle-celled sarcoma that I ever had the opportunity of 
examining was in a well-bred cow, whose cutaneous tissues 
were covered with innumerable ulcerating tumours, having the 
histological character of this form of sarcoma. 



MELANOSIS, OR MELANOTIC SARCOMA. 

Melanosis, described in the first edition of this work as black 
cancer, is found, upon further investigation, to belong to the 
sarcomata, or, as already stated, tumours consisting of embryonic 
connective tissue. 

In structure the sarcoma consists of connective tissue, which 
retains its embryonic characters and cells, and constitutes nearly 
the whole of the growth. The round cells are those generally, T 
may state, always found in the melanosis of the lower animals, 
and are similar in form to white blood corpuscles, but containing 
granules of dark pigmentary matter, which give the tumours 
their characteristic black appearance. 

The dark granules of pigment not only fill the cells, but lie 
free in the surrounding fibres, as shown in fig. 107 (c). 

Melanosis has hitherto been described as a benign disease in 
the lower animals, both by human and veterinary pathologists. 
Professor Spence says — "The melanotic cancer has this pecu- 
liarity, that a form of it occurs in the lower animals which cannot 
be distinguished from the black cancer in man. But in the 
former case it is not malignant, and has no tendency to return 
after removal, while in the human subject it is plainly and 
entirely a malignant disease — a melanotic form of cerebriform 
cancer." Paget says — "In the horse and dog, I believe, black 
tumours occur which have no cancerous character; but none 
such are recorded in human pathology." 

I have seen a great many cases of melanosis, but I never saw 
one in the horse, the history of which I could afterwards trace, 
where the disease did not return ; and if recurrence only were 
the special characteristic of malignancy, this would prove the 
true nature of the growth, without a shadow of doubt. But a 



436 SIMPLE TUMOURS. 

malignant is not the only growth that is liable to recur, hence 
the recurrent character of melanosis can only be taken as one 
fact to prove its malignity. 

I have also seen melanosis in horned cattle of various colours, 
but more particularly in those of a dark brown or black colour, 
and as a rule early removal has been effectual, and there has 
been no recurrence. 

A melanotic tumour has all the specialities of malignancy. 
1st. Its minute structure is not like any of the fully developed 
natural parts of the body. 2d. It is usually an infiltration ; 
and this characteristic is much more manifest than in medullary 
cancer ; although it may appear as separate masses, it will be 
found, on close examination, that the structures surrounding the 
tumour are deeply tinged with the pigmentary matter, and that 
they gradually disappear either by absorption or by being appro- 
priated as materials for the growth of the malignant disease. 
'6d. It has a tendency to enlarge, not only by growth, but 
apparently by multiplying itself in the formation of other 
tumours around it, or in more remote parts of the body. 4<A. 
Ulceration in melanosis is as constant as in the other malignant 
tumours. And, lastly, there is scarcely a tissue or an organ 
that melanosis may not invade. It may, therefore, be safely 
concluded that "melanotic or melanoid tumours are, with 
very rare exceptions, sarcomatous tumours, modified by the 
formation of black pigment in their elemental structures." 
It may also be mentioned that melanotic tumours in the 
human being have their favourite seats in or beneath pig- 
mentary moles. 

Melanosis is, with very rare exceptions, confined to grey 
horses, and becomes developed as they whiten with age. Its 
favourite seat is on the under surface of the tail, around the 
anus or vagina, or the perinseum; more rarely the scrotum, 
mammary gland, inner surface of thigh, and on the nose or lips. 
These are merely its outward manifestations ; for on dissection 
it may be found, either in large masses or as small multiple 
tumours, in the mesenteric, bronchial, deep inguinal, and lumbar 
glands, and in the spinal canal. I do not think that there is 
any part of the body that may not be affected by these tumours ; 
but I wish to confine myself strictly to those cases that have 
fallen under my own notice. 



MELANOSIS, OK MELANOTIC SARCOMA, 437 

In some cases there are no external tumours. The dissection 
of one case — death occurring from dropsy— revealed a melanotic 
mass, weighing six pounds, situated in the bronchial lymphatic 
glands. In another case a tumour was found in the inguinal 
plexus of glands weighing above eight pounds, which, previous 
to death, pressed upon the crural nerves, and caused paralysis. 
In the majority of cases, however, there has been some outward 
manifestation of the disease ; but in occult disease occurring in 
grey or very light chestnut horses, the practitioner ought to 
consider whether such disease may not be due to melanotic 
growths. 

The development of melanosis is looked upon as a new excre- 
tory function, set up for the purpose of eliminating from the 
system the pigmentary matter which is no longer required for 
the purpose of tinging the hair. If it were true that the pig- 
mentary matter was already formed in the blood, and only 
required to be appropriated by the structures to which it gave 
colour, the supposition would be justified ; but the fact is, pig- 
ment is not conveyed to a part, but is formed by the cells of the 
tissues in which it is found, out of materials supplied by the 
blood. We must, therefore, look upon melanosis as being due 
to an exalted formative power in the cells of the tissue in which 
it is found. "When formed in the skin of grey horses, we can 
easily understand that its pigmentary cells may be stimulated 
to increased activity by the blood, which one may suppose is 
highly charged with the ingredients from which pigment is 
formed. This would be merely an exalted natural action of the 
cells ; but when the pigmentary matter is formed by the cells 
of glands, or other structures than skin, we must look upon the 
process as a perverted formative action. 

Melanosis appears usually as a rounded tumour, small at first, 
but gradually enlarging in every direction within and upon 
those portions of the body which do not lose their black colour 
by age : or several of these small tumours may manifest them- 
selves simultaneously, enlarging by growth and by coalescence, 
and thus forming one large tumour. Other tumours form in 
the neighbourhood, and usually extend along the direction of the 
hairless skin of the tail, anus, and perinseum, until at last there 
is a most unsightly collection of them, like bunches of large 
onions. After a time they wither in the centre ; the skin 



438 SIMPLE TUMOURS. 

ulcerates by a slow, degenerate, and non-suppurative process — 
being seemingly converted into melanotic matter — and allows 
more or less of the contents of the tumour to escape. As the 
tumours grow the natural tissue of the part withers, its place 
being taken up by the melanotic matter. 

The animal does not seem to suffer much inconvenience, ex- 
cept from the effects of friction upon the surface of the tumour 
when it comes in contact with contiguous parts. Thus a tumour 
on the tail will become sore if it presses upon another tumour 
on the vagina, or if by its weight it presses heavily upon the 
opposing healthy skin, or when the tumour or tumours are so 
heavy as to prevent the animal from elevating its tail during 
progression. 

Without entering further into the details of the symptoms, it 
may be concluded that a black tumour in any part of the body 
may be called melanosis. 

Melanotic growths are neither very hard nor very soft, especi- 
ally the external ones. Those found in the internal parts of the 
body are much softer. The colour varies in shade from a dark 
brown to the deepest black. 

Melanosis is generally confined to aged animals, but I have 
seen it manifested in a five-year-old grey horse, and become 
rapidly developed in various parts of the body. 

The treatment of melanosis is early removal, when it, as well 
as other malignant growths, may be checked for a time; but, as 
already stated, its recurrent nature is so great as to preclude the 
hope of permanent eradication. 

LymphadenoTwa or Lymphosarcoma. — This is another form of a 
malignant and fatal growth occurring in all the patients of the 
veterinary surgeon, as well as in man, arising very often from no 
appreciable cause, being sometimes of very slow, sometimes of 
very rapid growth ; differing from other malignant tumours in 
one particular only, namely, that it seldom invades but one kind 
of tissue — that of the glandular system, but as certainly prov- 
ing fatal as a tumour presenting all the characteristics of the 
most potent malignancy. 

When of a very slow growth, and situated in some external 
glands — (I have seen it in the lymphatic glands of the head and 
neck remain passive as it were for years, ultimately develop in 
the internal organs, and prove fatal)— it is termed a lymfhoma^ 



MELANOSIS, OR MELANOTIC SARCOMA. 439 

consisting of ordinary lymphoid tissue, resembling in fact a 
hypertrophy of gland. In this form there is a well developed 
reticulum and endothelial plates, and a normal number of 
lymphoid cells ; whereas, when it becomes malignant, the cells 
increase to an enormous extent, the reticulum being at first 
scanty, but later on the reticulum becomes largely developed, 
with increase of the endothelial plates, and corresponding dimi- 
nution of the number of lymphoid cells. But, notwithstanding 
its cellular character, lympho-sarcoma has little or no tendency 
to undergo any degenerative changes; there is no softening, 
caseation, or calcification as in others, more particularly scrofu- 
lous glandular growths. 

SyTTvptoms and Clinical Characters. — In cattle these tumours 
originate most frequently in the lymphatic glands of the head 
and throat, sometimes commencing in the submaxillary, from 
thence to the parotidean region, often following the lymphatic 
tracks, and extending along the course of the trachea, involving 
the thyroid body, and invading the surrounding tissues, from 
which, however, it remains distinctly separated ; that is to say, 
it does seem to infiltrate into, but merely displaces, the sur- 
rounding tissues. 

I have seen these growths in cattle extending along the inter- 
muscular spaces in an upward as well as downward direction, 
and involve the face and upper cervical, as well as the inferior 
and lateral aspect of the throat, pressing upon the larynx, 
pharynx, and large veins, preventing free deglutition, respiration, 
and return of the blood from the head, which, in consequence, 
has soon presented a swollen cedematous condition, the animal 
being in consequence a miserable object. 

The effects of these tumours are similar to those induced by 
scrofula ; both are incurable, but lymphadenoma has no ten- 
dency to suppurate or ulcerate, whereas scrofulous or tubercular 
growths undergo degeneration, soften, and, to some extent, sup- 
purate, such suppuration giving relief, for a time at least, to 
distressing symptoms. 

I have not seen any external manifestations of lymphade- 
noma in the dog, but have met with masses in the spleen, 
mesentery Kver, and kidneys. In one instance, the weight 
of an agglomeration of these tumours, taken from a fox terrier, 
was as much as seven pounds — the symptoms prior to death 



440 SIMPLE TUMOURS. 

being hard enlargement of the belly, and some extent of 
dropsy. 

In the horse lymphadenoma is generally found invading the 
spleen and other abdominal organs — (see frontispiece, Veterinary 
Medicine) — and is then difficult of diagnosis ; the more salient 
signs being a wasting disease arising from no ostensible cause, 
or perhaps succeeding some trifling ailment. There is capricious- 
ness of appetite, stiffness of the back and loins, pallidity of the 
mucous membraaes, and loss of flesh. If there be no symptoms 
beyond these, the practitioner is under a great disadvantage; 
but if, in addition to the above, there be an appreciable increase 
of the colourless blood corpuscles, the diagnosis becomes less 
dif&cult, as leucocythemia — (not that it does not occur without 
chronic spleen dise'ase) — ^is, when associated with the above 
symptoms, characteristic of this condition. 

Other cases in the horse, which have fallen under my notice, 
have had well developed glandular growths about the throat 
and subscapular glands, which, increasing in size, press upon 
contiguous organs, and thus become a source of inconvenience 
to the animal. 

In two horses that came under my notice, the glands of the 
throat became so enlarged as to necessitate tracheotomy to 
relieve the distressed breathing. In another the subscapular 
glands were enormously enlarged — the growth being very rapid 
in this instance. All of these became subject to intermittent 
colicky pains, finally becoming emaciated, and, after the death, 
had enormous growth in the spleen, clusters of smaller tumours 
in the liver, kidneys, in the mesentery, and in the lungs. 

In some cases of farcy, lympho-sarcomatous growths are found 
in the spleen and other organs. I think, however, that they are 
mere coincidences, as the majority of farcied horses present 
none of the growths, whilst the tumours exist independent of 
eCLuina poison. 

In some instances the development of the splenic tumours is 
associated with an appreciable increase of the white blood cor- 
puscles, anaemia, pallor of the mucous membranes, capriciousness 
of the appetite, more or less rapid emaciation, stiffness of the 
back and loins, hanging back the full length of the halter or 
head-collar (in one case a continual curling and twitching of the 
upper lips, and resting the teeth upon the edge of the manger), 



TWO VIEWS OF THE RAT FUNGUS (ACTINOMYCES) 
UNDER DIFFERENT MICROSCOPIC POWERS. 

Stained with Heneaoe Gibbes's Tdbbeole Bacillus Stain, and MonNiED 
IN Canada Balsam. 

Via, 91. 






Fibrous Tissue. 




mtA 



c«< 



X 500. 



Fig. 92. 



„ Mycelium. 



Conidia. 



Sarcomatous Cells. 






<•' '.V, se 






'f^eS0iisi^,t>^. 



^w 



A \«. 



Vi;7 i/J!'' 






W. 0. w. 



X 250. 



ACTINO-MYCOSIS. 441 

scraping -with the fore feet, and occasionally ■well-marked 
colicky symptoms. 

In the majority of cases the spleen becomes enormously 
enlarged, being 70, 80, or 100 lbs. in weight; in one case over 
200 lbs. When of such enormous size, there will be enlarge- 
ment of the abdomen, and a possibility of diagnosing by external 
manipulation and examination per rectum. 

Microscopically examined, these tumours are found to consist 
of a reticular stroma, made up partly of anastomosing ramifying 
cells, containing a multitude of round cells in its meshes, as 
in figure 89. 

If a thin fresh section of a tumour is shaken with water so 
that the lymphoid cells are washed out, the structure can be 





I"IG. 89.— Mass of cells in meshes I'M. 90.— Thin section from which 

of reticulum. many of the cells have been washed and 

pencilled out. 

more easily made out under the microscope, and the appearance 
presented in fig. 90 will be seen. 



ACTINO-MYCOSIS. 

This malignant growth may be classified as a parasitic tumour, 
consisting of the development of cellular sarcomatous elements 
from an Trritation caused by the presence of a vegetable parasite 
—the actinomyces or ray fungus— a radiating or star-like vege- 
table parasitic growth, as shown in fig. 91. 

The botanical position of this fungus is not yet determmed. 



442 SIMPLE TUMOUES. 

some pathologists going so far as to question its vegetable origin, 
as it differs in many respects from its congeners. 

Actino-mycosis is described by Ziegler as a progressive inflam- 
matory affection set up by the fungus — actinomyces — and that 
it results in the formation of fibrous tissue granulations, and in 
suppuration. It attacks human beings, cattle, swine, and sheep ; 
it has also been seen in the dog, and is communicable by in- 
oculation, but the horse seems to resist even this test. 

In cattle, the masses or tumours seldom suppurate, and some- 
times attain the size of a goose's egg, affecting the tongue, the 
lower and upper jaws, and it has been discovered in other parts 
of the alimentary tracks, the lungs, skin, &c. 

The disease was described by Eivolta in 1875, by Bollinger 
in 1877, and since then has been subjected to investigation by 
several observers. Previous to this period it was known in this 
country as scirrhus of the tongue, malignant epulis, tubercular 
stomatitis, and osteo-sarcoma. It consists of a gradual develop- 
ment in the tissues of the tongue, jaw, or other parts of a fungus, 
which, on reaching its full development, is a peculiar gland-like 
body, outwardly resembling a mulberry, produced by the aggrega- 
tion of the club-shaped conidia of the parasite. 

When affecting the tongue, it causes that organ to swell, and 
sometimes to attain a weight of 10 to 12 lbs., and it is soon 
covered by numerous irregular shaped masses resembling warts, 
varying in size from a pin's head to that of an egg or larger. 
They are of a pale yellow colour, and are more or less soft in 
consistence, and the larger ones having generally broken through 
the buccal membrane. 

The swelUng and the tumours cause the tongue to lose its 
mobility; hence the patient eats with difficulty, and rapidly 
loses flesh, and as the disease is incurable, the animal should 
be sent to the butcher. 

On post mortem examination, it will be found that the tissues 
of the tongue are difficult to cut with the knife, and that the 
cut surface presents numerous yellowish white or greyish 
nodules imbedded in its tissues. 

THE CAKCINOMATA. 

Cancerous tumours are growths characterised by the develop- 
ment of irregularly shaped cells of an epithelial type, each 



p^yM*y ,-'■ 



CARCIXOMA.TA — SCIEUHUS. 4-13 

containing one or more nuclei and distinct nucleoli, grouped in 
rounded or variously shaped connective spaces termed alveoli, 
and wliich are said to be in direct communication with the 
lymphatics at the margins of the tumour, each alveolus having 
a boundary or wall of fibrous tissue, called the stroma. They 
are divided according to the amount and nature of the stroma, 
and the number and character of the cells, into hard, epithelial, 
and soft cancers. 



HARD CANCER, OR SCIERHUS, 

Is dense and white in its structure, arranged in masses, with 
projections passing from its centre to various parts of the organ 
which it attacks. It cuts up almost like cartilage, and after 
being cut the surfaces both become concave, and the haemor- 
rhage from them is uniform, without jet, and more excessive 
than from the surrounding tissues. It differs from a simple 
tumour by being more rapid in its growth, by its tendency to 
involve the lymphatic glands, to break through the organ in 
which it is developed, and to involve neighbouring textures. 
When developed in the mouth and face, it interferes with the 
process of mastication, and causes the animal rapidly to lose 
flesh ; but when it is so situated as not to interfere with any of 
the animal or vital functions, it does not seem to affect the 
constitution for a long period, or until ulceration has taken place. 
The ulcer then involves the adjacent parts, and a fungus is 
thrown out, haemorrhage occurs, and the patient suffers from 
irritation and exhaustion. 

The only treatment is early removal, if the tumour is situated 
in a part where an operation can be performed. The applica- 
tion of escharotics is not to be recommended, excision being by 
far the better method. In the mammae of dogs the operation 
nearly always affords relief, if the brachial or inguinal glands be 
not affected. I have operated on many cases, and always with 
success ; but I have taken care not to do so when the glands are 
much enlarged ; but if the external gland be enlarged, and when 
it can be ascertained that internal ones are not involved, the 
formal as well as the original tumour are to be excised. 

Professor Bennett has suggested a method of destroying 



444 TUMOUES. 

cancer, by injecting weak acetic acid into the tumour. The 
suggestion has arisen from the fact that acetic acid destroys 
the cells of cancer, transforming them into amorphous matter. 



SOFT CANCEE. 

This is met with in two forms, namely, medullary sarcoma 
or cerebriform tumour, and the colloid, alveolar, or gelatini- 
form, as it is variously named. The term colloid seems to be 
preferred by modern writers. 

(1.) Colloid Cancer. — I have met with specimens of colloid 
cancer, since the publication of the first edition of this work, in 
the ovaries, kidneys, and in the brachial lymphatics. The 
specimens, as well as one met with in the duodenum of the 
horse by Dr. Young, were found to correspond with those seen 
in human beings, in whom it is found as a primary disease, 
principally in the digestive organs, uterus, mammary gland, and 
peritoneum : and, as a secondary disease, in the lungs and 
lymphatic glands. It consists of fibres so arranged as to form 
alveoli or spaces, varying in size, and containing a soft, viscous, 
and nearly liquid matter, grey or amber-like in colour, but 
sometimes opaque, and of a greenish yellow hue. This is the 
true colloid, or glue-like substance. The density of the tumour 
will depend upon the proportions of its two constituent 
materials. If the colloid matter predominates over the fibrous 
material, the tumour will have a soft, fluctuating feel, and will 
be made up of large masses of colloid substance, intersected by 
white fibrous cords or thin partitions, arranged as in areolar 
tissue. But when the fibrous texture is predominant, the 
tumour will appear as a tough, white, fascia-like mass, con- 
taining small separate cavities or cysts filled with the colloid 
substance. 

(2.) Medullary cancer is developed in the form of circum- 
scribed tumours or infiltrations. The case from which the 
specimen seen in Photo-lithograph, Plate IV., Fig. 4, was taken, 
presented both varieties, the circumscribed, as well as the in- 
filtrated form, in the mammary region ; infiltrations only in the 
submaxillary space, and one M'ell-defined circumscribed tumour 
(that represented in the figure), weighing four pounds, upon the 
outer side of the thigh. 



SOFT CANCEE. 445 

Many names have been given to this variety of cancer, such 
as fungus-hsematodes, cephaloma, encephaloma, encephaloid, 
carcinoma meduUare, medullary fungus, medullary sarcoma, 
&c. It is found in the glands, in the inter-muscular struc- 
tures, in the penis, scrotum, the orbit, submaxillary space, and 
in the bones and periosteum. — (See Photo-lithograph, Plate 
IV., Fig. 6.) 

Medullary cancer may present itself as one tumour ; but when 
cut into, it will be found, as a rule, to be made up of several 
smaller ones, enclosed in a distinct wall or boundary ; or its 
multiple character maybe defined by external examination. To 
the touch it presents a peculiar soft elastic feel of the slow fluc- 
tuation of some thick liquid, which may be taken for pus or 
serum by an inexperienced examiner. The veins over the tumour 
are congested ; the skin retains its natural appearance for a long 
time; but eventually becomes tense and painful, the pain 
being referable to the tension of the nerves and surrounding 
tissues — the tumour itself not being sensitive — and then 
ulcerates and bleeds. Ulceration does not take place very 
readily; but when it occurs, a fungous growth soon appears, 
and much of the brain-like matter of which the tumour is 
composed, along with much blood, is discharged. A separable 
medullary cancer may, as a whole, present a very irregular sur- 
face, having a tendency to extend in the direction of the inter- 
muscular spaces, as in one case, where I found it in the walls of 
the abdomen. In this instance the tumour was almost of a 
triangular shape, with its base turned backwards, extending for 
about fourteen inches under the panniculus carnosus, and 
adapting itself to the form of the spaces existing between the 
pectoralis magnus and serratus magnus muscles. But though 
the mass may be irregular in the aggregate, its component lobes 
are round or oval, and readily adapt themselves to surrounding 
parts. They grow deeply in loose areolar spaces, but their 
boundaries are more superficial where the surrounding struc- 
tures are firm. The parts around the lobes are not usually 
infiltrated, as each lobe is surrounded by a more or less distinct 
capsule, which seems not only to enclose each individual lobe, 
but to extend over and involve the whole tumour. This is 
easily separated from the surrounding structures, and when cut 
into allows its contents to protrude, or, when very soft, to ooze 



446 SIMPLE TaMOUES. 

out. The blood-vessels, which are numerous in the capsule, are 
tortuous in their course, peculiarly friable in their texture, and 
usually surrounded by the medullary matter. This friability of 
the vessels renders it very difficult to apply ligatures, as the pres- 
sure required to arrest the hsemorrhage usually breaks through 
the easily lacerable vessels. 

When cut into, the lobes are seen to be composed of a peculiar 
soft substance (the medullary matter), which is easily broken 
and spread out with the fingers. It resembles reddish-coloured 
brain matter, and is sometimes softer than brain. I have never 
seen it white, as described by human pathologists ; but the tint 
is usually clear, that is to say, there is no purulent or fibrinous 
opacity. Masses of a peculiar looking substance are seen in it. 
These are yellowish, rounded bodies, similar to very small cysts, 
and in mass resembling Indian meal or coarse porridge. This 
matter is often found between the lobes, as well as within them. 
In their centres the contents of the lobes are seen to be under- 
going fatty degeneration. 

When the cancer is pressed or scraped, it yields a turbid 
material, " cancer juice," and leaves a small quantity of fibrous 
tissue, with numerous blood-vessels. This, as well as the cancer 
juice, is formed during the growth of the cancer, and therefore 
differs from the " stroma of scirrhus " by being part of the malig- 
nant growth, and not of the tissue in which it grows. 

It was supposed at one time that the vascular system of these 
cancers was either exclusively venous or arterial ; but it is now 
proved, by the ■ experiments of Lebert and others, that they 
contain arteries, capillaries, and veins, arranged in networks of 
varying closeness ; and it is also probable that the difficulty of 
injecting veins in some of them is due to their being filled with 
cancerous matter, which stop the injection, after it has tra- 
versed the capillaries. The vessels are very abundant, and are 
not only friable in structure, but defective in muscular tonicity, 
hence their liability to bleed when the tumour ulcerates, or 
when wounded accidentally ; and it is due to this that the name 
fungus-hsematodes has been applied. 

Medullary cancer may arise from an accidental injury, such 
as a blow or wound. In a case of cancer of the side of thorax 
and abdomen, the tumour arose in the cicatrix of an old 
wound ; the tvimour had been present for several years, and 



\ \ 



EPITHELIAL CANCER, 447 

gradually increased in size, until it became unsightly, and inter- 
fered with the application of the saddle-girths. 



EPITHELIAL CANCER. 

Epithelial cancerous tumours, also known as epithelioma 
or cancroid, consist of a fibrous stroma, in which papillae and 
epithelium are found greatly multiplied and enlarged. The cells, 
when microscopically examined, are found to be numerous, flat, 
round, oval, or elongated, containing a simple nucleus; and 
other cells containing large nuclei, which appear as if in process 
of development into cells. They differ but little from the 
natural epithelial cells of the part ; and as the minute structure 
of this form deviates least of all the cancers from the natural 
structures upon which it grows, so its course and history exhibit 
but little malignancy. 

Its chief site is the skin and mucous membranes, but particu- 
larly at the junction of the two; as the mouth of mucous 
orifices, the vulva, anus, eyelids, and edges of the mouth. It is 
a very rare form in the lower animals ; arises from some 
previous local disease or injury ; and is seen more frequently in 
dogs than in the other domesticated animals. — (Fig. 93.) 




j"l(j. 93. Section of epithelial cancer from palate of the ox, showing large 

flattened cells, with numerous smaller ones enclosed in a fibrtius matrix. 



2S0 diam, 



CHAPTER XXIV. 

WOUNDS. 

DEFINrnON — CLASSIFICATION — INCISED — PUNCTURED — LACERATED — 

CONTUSED GUNSHOT POISONED TREATMENT OF WOUNDS 

SUTURES COLLODION STYPTIC-COLLOID SHELLAC PASTE 

NON-INTERFERENCE. 

The term wound signifies a recent solution of continuity of the 
living tissues induced by some mechanical cause. 

Wounds are classified under the following heads: — Incised, 
punctured, lacerated, contused, gunshot, and poisoned. 

The various modes of healing are considered in the following 
order, namely: — 1. By immediate union; 2. By primary ad- 
hesion; 3. By granulation; 4. By secondary adhesion, or the 
union of granulations ; 5. By healing under a scab. These five 
modes are sometimes called : — 1. By the first intention ; 2. By 
the adhesive inflammation; 3. By the second intention; 4. By 
the third intention ; 5. Subcrustaceous cicatrisation. 

1. Incised wounds. — ^An incised wound is that made with a 
clean-cutting instrument. The textures are divided evenly and 
smoothly; there is no tearing or bruising of parts, hence the 
haemorrhage is at first much greater than in most other wounds. 
If the wound has been parallel to the course of the muscular 
fibres of the part, there is no gaping of the edges so long as 
the part is kept in position ; but if the cut be across the direc- 
tion of the muscular fibres, or transverse to the axis of a limb, 
the wound will be drawn apart, the deep parts more so than 
the superficial, owing to the retraction of the divided muscular 
fibres, and a cavity formed in which blood and pus are apt to 
coUect and retard the progress of repair. 

The treatment of this sort of wound is very simple, but it 
comprehends four important indications, namely — 1, To arrest 



INCISED WOUNDS. 449 

haemorrhage; 2. To remove foreign bodies; 3. To effect and 
maintain co-adaptation; and 4. To guard against excessive 
inflammation. (1.) Heemorrhage, whether artificial or venous, 
is to be arrested, and this is the first thing that must be attended 
to. If it arises from a small artery partially cut, blood of a 
bright red colour flows or spurts out in jets ; but if it be com- 
pletely cut across, the ends contract, and the haemorrhage ceases. 
In some cases the bleeding will continue although the artery be 
divided completely across, or wiU take place from time to time, 
and prove serious. In such instances the end of the artery must 
be searched for, drawn out by the forceps, and tied by a ligature ; 
occasionally it will be found necessary to enlarge the wound to 
do this effectually. 

Venous bleeding is generally easily arrested by moderate 
pressure, or by an astringent application, such as a solution of 
the tincture of terchloride of iron. As a rule, even these slight 
applications are unnecessary, venous bleeding stopping spon- 
taneously if the wound is exposed to cold air ; but if a large 
vein be wounded, it is often necessary to tie it with a ligature. 

When the bleeding is arrested, all clots of blood, dirt, and 
foreign bodies are to be removed from the wound by careful 
sponging with tepid water. In sponging a wound, care must 
be taken not to injure its surface by any undue pressure. It 
is quite sufficient to squeeze the water out of the sponge on to 
the wound, without the sponge being brought into contact with 
it. This is easily done by placing the sponge at a little dis- 
tance above the wound, and allowing the water to flow gently 
over the wounded surface. If any materials are firmly im- 
bedded in the tissues, they must be removed by the forceps or 
the point of the finger. Cleaning wounds with a coarse brush 
cannot be too highly condemned. 

In wounds where muscular fibres are deeply cut, it is recom- 
mended, more especially by Mr. Syme, that the wound should 
remain open for about eight hours, for the purpose of allowing 
the discharges of blood and serum to escape ; or if sutures are 
immediately employed, they should be applied in such a loose 
manner as to allow the blood and serosity to escape, and all 
clots which may afterwards form washed out. This is good 
practice, and ensures healing by adhesion in many cases that 
would otherwise run on to the more tardy process of granulation. 

2g 



450 ■WOUNDS. 

In many large ■woimds sufficient room for the escape of the 
discharges, which are always profuse for the first few hours, 
may be obtained by omitting one or even two sutures at the 
most dependent part of the wound, which, if it be parallel to 
the axis of the limb and the direction of the muscular fibres, 
is easily brought together and maintained so by a few sutures, 
placed about an inch apart. If the wound be transverse to the 
direction of the limb or muscular fibres, with a cavity formed 
by the retraction of the divided muscular fibres, it is difficult to 
bring its lips into apposition ; and even when they are co- 
adapted by firm and strong sutures, the skin into which they 
are inserted is almost sure to slough, the process of healing 
being at the same time retarded by the irritation set up, and 
the blemish increased to a considerable extent. In such cases 
the best plan is to bring the lips together at their extremities, 
using the quiUed suture, and leave a gap at the central portion 
of the wound ; or, if the cavity be very deep and in a downward 
direction, it may be necessary to make a counter-opening at its 
inferior part, to allow the discharges to escape. If such be the 
case, the lips of the original wound are to be brought together, 
and it is possible they may heal by the adhesive process. 

The edges of wounds are kept in apposition by means of 
sutures, pins, plasters, and bandages. Plasters are rarely used 
in veterinary practice, but their employment, especially in 
wounds in the lower portions of the extremities, may with 
advantage be preferred to that of sutures, as they cause no 
blemish. A longitudinal or even transverse wound situated on 
a leg is easily brought together by plasters, over which a 
moderately firm bandage can be applied; and a wound so 
treated wiU heal in less time, and leave a smaller blemish, 
than when sutures are employed. 

Various forms of sutures are employed for keeping the edges 
of wounds together ; the interrupted suture is, however, the form 
mostly in use, and the material "the metallic suture wire." 
The wire causes less irritation than thread, and is to be always 
used in preference. It can be had in thickness and strength 
adaptable to almost all wounds, with needles grooved for the 
purpose, from the instrument makers. 

The twisted suture, or the pinning of wounds, is performed 
as follows : — Having brought the lips of the wound nearly into 



INCISED WOUNDS. 451 

contact, a " pin-director," -with the pin in its concavity, is to be 
introduced from the outside inwards, and carried out through 
the opposite side to the same distance from the edge that it 
entered on the former side; the director is then withdrawn, 
and the pin left in and secured in its position by a firm wax 
ligature passed around it, making the figure of 8, by which the 
wounded parts are drawn gently into contact. The number 
of pins is to be determined by the size of the wound ; three- 
quarters of an inch to one inch is a proper distance between 
two pins. 

TTm, Quilled, Sutwe. — When pressure is required on the deep 
as well as the superficial parts, this form of suture is employed. 

This suture is best applied with a strong curved needle, fixed 
in a handle, and having an eye near the point. This can be 
threaded with the loop of double twine, strong thread, or catgut. 
The needles must pierce the skin not closer than an inch from 
the edge, deeply inserted, and brought out at the same distance 
beyond the opposite margin of the wound. This will leave a 
double thread through the wound, with a loop on one side and 
two free ends on the other. Through each loop so formed a 
piece of whalebone or cane should be passed, and the threads 
firmly drawn over it, while the free ends are firmly tied over a 
similar piece on the opposite side of the wound. To maintain a 
more perfect apposition in the more superficial parts, a few in- 
terrupted sutures may be inserted to the margins of the wound. 

When an injury is superficial, sutures are not required ; and 
in parts where plasters cannot be applied they can be kept in 
apposition by collodion, styptic-colloid, or, what is more economi- 
cal, a thick solution of shellac in methylated spirit, which may 
be prepared and kept ready for use in a wide-necked bottle with 
a tight-fitting cork. 

As to local applications to incised wounds, fortunately the 
days are past when greasy ointments, friars'-balsam, black oils, 
and other irritating abominations were made use of, and now-a- 
days wounds are left alone. If anything be done at all, the 
best application to the surface of the skin around the wound is 
the ordinary white lotion, gently squeezed out of a sponge, and 
allowed to trickle over the surrounding skin ; care being taken 
that the sutures are not disturbed, nor the dried discharge 
which covers the surface of the fissure removed. Tomentations 



452 WOUNDS. 

with hot or cold water are also objectionable, because they 
increase the discharge from the wounded surfaces, disturb the 
sutures, and invariably bring on the suppurative action. 

If all goes on well, the sutures are to be carefully removed at 
the end of the fifth or sixth day, when it wUl be found generally 
that the wound has fairly united ; but should the lips begin to 
gape, the surrounding parts to inflame, pus be discharged, the ' 
sutures to drag, and cut the skin, some of the sutures at least 
must be removed, the wound gently bathed with tepid water, 
and its surface dressed with very dilute carbolic acid, a solution 
of iodine, or the latest antiseptic dilute boracic acid. In warm 
weather, and in cases that begin to inflame, tow or lint dipped 
in cold water may be gently laid over the wound, and retained 
in position by a light bandage placed at a little distance from 
the wound. This should be occasionally wetted with cold 
water in which carbolic acid has been dissolved. It is, how- 
ever, better not to interfere in any way, except when absolutely 
necessary. 

21ie Constitutional Treatment. — Prescribe a cooling diet ; ad- 
minister a gentle purgative, and order quietude. 

The application of oiled sUk, thin gutta-percha, or any other 
waterproof covering to the wet dressings, is objectionable in 
veterinary practice, more especially in horse practice, as the 
parts so confined are apt to become highly inflamed, and the 
skin blistered. 

2. Punctured wounds are produced by the penetration of a 
sharp or blunt pointed instrument into the tissue usually to a 
depth disproportionate to the aperture of entrance. Punctured 
wounds are the most dangerous of all wounds, and for the 
reasons that, from their depth, they are liable to implicate 
arteries, nerves, veins, viscera, and deep-seated vital parts; 
that the parts which they traverse are stretched and torn, and 
consequently are disposed to inflame and suppurate ; and pus, 
when formed, has no free exit, and is liable to burrow exten- 
sively ; that foreign bodies may be carried to great depths with- 
out being suspected, and create long-continued irritation ; and 
finally, punctured wounds are most liable to be followed by 
tetanus. 

^ The treatment of punctured wounds must be conducted in 
ccordance with the gravity and depth of the puncture, and the 



PUNCTURED WOUNDS. 453 

amount of laceration and contusion. If the wound be shallow, 
attended with little or no bruising, and free from foreign mat- 
ters, adhesion may be possible, and ought to be promoted ; and 
so long as oozing continues from the orifice, cold water bathing 
IS to be practised. When no more blood or serosity issues, a 
pledget of tow dipped in collodion, or the shellac solution, is to 
be placed over the opening so as to cover it entirely, or with the 
exception of its most depending part. 

The animal is to be kept quiet ; a purgative given, and a mash 
diet prescribed. 

In more serious cases, or in the simpler ones, when inflamma- 
tory swelling supervenes, the wound must be dilated freely. 

In deep punctured wounds, with haemorrhage, it may be neces- 
sary to dilate in order to secure an artery, or to remove a foreign 
body ; and in the minor punctures, often seen in the neighbour- 
hood of the elbow, it is important to bear in mind that there is 
great risk of sub-fascial suppuration if dilatation is not practised 
early. If there be much tension the skin and subcutaneous fascia 
are to be divided longitudinally and to the same extent. Then 
the fascia is to be divided transversely, so as to make a crucial inci- 
sion in it ; this will relieve all tension. The same rule applies to 
partially divided muscular fibres; theymust be divided thoroughly 
and completely, both by a longitudinal and a transverse inci- 
sion, so as to give free vent tp any discharges from the deeper 
parts of the wound. 

When this is done, warm fomentations are to be frequently 
and freely applied; and in situations where poultices can be 
adjusted, they should be employed — (boiled turnips form, 1 
think, the best poultice ; they are very soft, and retain their 
moisture for a longer time than bran or linseed meal) — and the 
surface of the wound dressed with white lotion or opium, and 
water. 

The constitutional treatment; must be directed to relieve pain 
by opium, and the accompanying fever by a purgative, aconite, 
and antiphlogistic diet. If the puncture be in a foot or limb, with 
excessive lameness, and inability to lie down, the slings must be 
early employed. 

Fungous protrusions or excessive granulations on the surface 
of the wound are not to be irritated by caustic applications ; 
they are the tissues of the part, swollen and congested, agjl,|^i;' 



454 "WOUNDS. 

disappear when tlie inflammation subsides. If, however, after 
the inflammation has been subdued, the exuberant granulations 
continue in the wound, they are to be destroyed, and the tissues 
stimulated to healthy action by being touched with the nitrate 
of silver. In some instances, owing to debility of constitution, 
these granulations continue as flabby, pale-looking excrescences, 
notwithstanding efforts to repress them, discharging a sero-puru- 
lent matter. Their repression will then be best effected by atten- 
tion to the constitution of the animal, and by repeated applica- 
tions of astringents. 

Fungous gi'anulations are very often caused by injudicious 
bandaging, and in many instances where bandages have been 
applied to a wounded part they will entirely disappear upon the 
discontinuance of the bandages, and if a wound from which 
foreign bodies have been removed is not irritated by bandages, 
undue interference, or what are termed digestive ointments, no 
sprouting of proud-flesh will occur. There are, however, excep- 
tional cases, and it may be necessary in these to support the 
vessels of the part, and repress the granulations, by properlj'' 
adjusted bandages. Their effects are to be closely watched, for 
generally they irritate the wound and excite fungous growths. 

Sulphate of copper, either in solution or as a fine powder, is 
very generally app